Most Relevant Information
Provider Data
| NPI Number: | 1003247743 |
| Provider Name: | BETHANY SMITH |
| Entity Type: | Individual |
| Taxonomy Code: | 171W00000X |
| Specialty: | Contractor |
| License Number: | 20238 |
Most Important Dates
| Enumeration Date: | 12/05/2013 |
| Last Updated: | 12/05/2013 |
Provider Practice Location
559 GLATT CIR STE 1
WOODBURN
OR
970719675
Practice Location Phone/Fax
| Phone: | 5039814591 |
| Fax: | 5039823308 |
Provider Mailing Location
559 GLATT CIR STE 1
WOODBURN
OR
970719675
Provider Mailing Phone/Fax
| Phone: | 5039814591 |
| Fax: | 5039823308 |