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NPI Code Detail

MEDICARE: KAYLA DAWN SMITH MA

MEDICARE: KAYLA DAWN SMITH MA
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
1101Y00000XCounselorOR

General Provider Information

NPI Number : 1649737115
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA DAWN SMITH MA
Provider Business Mailing Address
First Line : 1802 N PINE ST APT D300
Second Line :
City : CANBY
State : OR
Zip : 97013-4462
Country : US
Telephone Number : 503-413-9370
Fax Number :
Provider Business Practice Location Address
First Line : 2222 E POWELL BLVD
Second Line :
City : GRESHAM
State : OR
Zip : 97080-1365
Country : US
Telephone Number : 503-699-4300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2019
Last Update Date : 02/21/2019

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Directions to “ KAYLA DAWN SMITH MA” Practice Location

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