MEDICARE: DR. ALLISON BROOKE SMITH N.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175F00000X	Naturopath	1689	OR

General Provider Information

NPI Number	:	1306174743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALLISON BROOKE SMITH N.D.

Provider Business Mailing Address
First Line	:	200 NE 20TH AVE
Second Line	:	SUITE 120
City	:	PORTLAND
State	:	OR
Zip	:	97232-3094
Country	:	US
Telephone Number	:	503-239-1579
Fax Number	:	503-236-6173

Provider Business Practice Location Address
First Line	:	200 NE 20TH AVE
Second Line	:	SUITE 120
City	:	PORTLAND
State	:	OR
Zip	:	97232-3094
Country	:	US
Telephone Number	:	503-239-1579
Fax Number	:	503-236-6173

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/23/2009
Last Update Date	:	11/23/2009

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