Healthcare Provider Details

I. General information

NPI: 1972930568
Provider Name (Legal Business Name): COURTNEY CATHERINE SMITH DVM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2013
Last Update Date: 09/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1134 NW 18TH ST
CORVALLIS OR
97330-2620
US

IV. Provider business mailing address

2625 SWYERS DR
HOOD RIVER OR
97031-9424
US

V. Phone/Fax

Practice location:
  • Phone: 541-490-4647
  • Fax:
Mailing address:
  • Phone: 541-490-4647
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number18867
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: