| Doctor Name: | MS. SUSAN IRENE SMITH |
| NPI Number: | 1003127515 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, FNP |
| License Number: | 200250149NP FNP-PP |
| Business Practice Address: | 5100 Sw Macadam Ave Suite 200 Portland, OR - 972396102 |
| Business Phone Number: | 9712025500 |
| Business Fax Number: | 9712025555 |
| Mailing Address: | 5100 Sw Macadam Ave, Suite 200 PORTLAND |
| State: | OR |
| Postal Code: | 972396102 |
| Phone Number: | 9712025500 |
| Fax Number: | 9712025555 |
| NPI Enumeration Date: | 06/30/2010 |
| NPI Last Update Date: | 01/23/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 200250149NP FNP-PP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |