MEDICARE: MS. GAIL R SMILEY M.S, L.P.C.

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	101YM0800X	Mental Health Counselor	OR677	OR

General Provider Information

NPI Number	:	1316187826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GAIL R SMILEY M.S, L.P.C.

Provider Business Mailing Address
First Line	:	7912 SW 35TH AVE
Second Line	:	SUITE 6
City	:	PORTLAND
State	:	OR
Zip	:	97219-2427
Country	:	US
Telephone Number	:	503-245-0088
Fax Number	:	503-638-9953

Provider Business Practice Location Address
First Line	:	7912 SW 35TH AVE
Second Line	:	SUITE 6
City	:	PORTLAND
State	:	OR
Zip	:	97219-2427
Country	:	US
Telephone Number	:	503-245-0088
Fax Number	:	503-638-9953

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

Provider Enumeration Date	:	02/23/2009
Last Update Date	:	02/23/2009

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