Smith, Kevin Ray

Smith, Kevin Ray is an individual health care provider with primary practice located at 3181 Sw Sam Jackson Park Rd Up, Portland OR 97239-3011. He recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Psychiatry, which is considered as his primary health care specialty. Smith, Kevin Ray can be contacted via phone (503) 494-8617.

Contact Information

Primary practice address
3181 Sw Sam Jackson Park Rd Up Portland OR 97239-3011
Phone: (503) 494-8617
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Psychiatry 2084P0805X MD18891 Oregon

Profile Details

NPI number 1366450801
LBN Legal business name Smith, Kevin Ray
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366450801 NPPES
Oregon MEDICAID 151231

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