Doctor Name: | PETER W. SMITH |
NPI Number: | 1043500556 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MS |
License Number: | |
Business Practice Address: | 702 Sunset Dr Ontario, OR - 979143121 |
Business Phone Number: | 5418899167 |
Business Fax Number: | 5418897873 |
Mailing Address: | 702 Sunset Dr, ONTARIO |
State: | OR |
Postal Code: | 979143121 |
Phone Number: | 5418899167 |
Fax Number: | 5418897873 |
NPI Enumeration Date: | 04/18/2011 |
NPI Last Update Date: | 02/06/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |