Individual
NIKKI SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2355 STATE ST STE 101, SALEM, OR 97301-4541
(503) 351-1437
Mailing address
PO BOX 1531, SANDY, OR 97055-1531
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
9047
OR
Other
Enumeration date
10/29/2024
Last updated
10/29/2024
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