Smith, Tina I

Smith, Tina I is an sole proprietor health care provider with primary practice located at 3211 Autumn Chase Way Ne Apt 104 , Salem OR 97305-1561. She recently has 3 registered licenses in different health care specialties including Other Service Providers / Community Health Worker, Other Service Providers / Specialist, Other Service Providers / Peer Specialist. Other Service Providers / Peer Specialist is her primary health care specialty. Smith, Tina I can be contacted via phone (971) 239-9675.

Contact Information

Primary practice address

3211 Autumn Chase Way Ne Apt 104 Salem OR 97305-1561

Phone: (971) 239-9675

Fax:

Website:

Map and Directions

Health care specialties

Specialty	Code	State
Other Service Providers / Community Health Worker	172V00000X	Oregon
Other Service Providers / Specialist	174400000X
Other Service Providers / Peer Specialist	175T00000X

Profile Details

NPI number	1053757948
LBN Legal business name	Smith, Tina I
Credentials	PSS
Entity	Individual
Sole proprietor ¹	Yes
Enumeration date	May 17th, 2013
Last updated	Dec 22nd, 2015 - about 10 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

State	Type	Number	Issuer
All States	NPI	1053757948	NPPES
Oregon	MEDICAID	O5329

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