Individual
SEAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
847 NE 19TH AVE, PORTLAND, OR 97232-2684
(503) 238-0769
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201905335RN
OR
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
07/09/2019
Last updated
07/19/2019
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