Provider Demographics
NPI:1871760835
Name:SMITH, KATHRYN RUTH (ND)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:RUTH
Last Name:SMITH
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2305 SE 50TH AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97215-3853
Mailing Address - Country:US
Mailing Address - Phone:503-837-3538
Mailing Address - Fax:038-373-5385
Practice Address - Street 1:2305 SE 50TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97215-3853
Practice Address - Country:US
Practice Address - Phone:503-837-3538
Practice Address - Fax:503-837-3538
Is Sole Proprietor?:No
Enumeration Date:2008-05-09
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1562175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath