Individual
REBECCA LIN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4591 AVALON ST, EUGENE, OR 97402
(541) 953-8150
Mailing address
4591 AVALON ST, EUGENE, OR 97402
(541) 953-8150
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
200930312LPN
OR
Other
Enumeration date
10/15/2009
Last updated
10/15/2009
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