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General NPI Number Information
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NPI Number | 1609312016
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Entity Type | Individual
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Provider Name | KAREN ANN SMITH MAPC
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Gender | Female
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Dates
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Enumeration Date | 01/09/2017
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Last Update Date | 01/09/2017
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Provider Practice Location Address
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Address Line | 260 SW MADISON AVE STE 107
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City | CORVALLIS
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State | OR
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Zip | 97333-4728
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Country | US
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Telephone | 541-241-3301
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Fax |
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Provider Business Mailing Address
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Address Line | 218 NW 21ST ST APT 2
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City | CORVALLIS
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State | OR
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Zip | 97330-5585
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Country | US
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Telephone | 541-254-0099
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number | R4520
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License Number State | OR
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