Smith, Roger Joseph
Smith, Roger Joseph is an individual health care provider with primary practice located at 676 Ne Negus Way , Redmond OR 97756-8527. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Smith, Roger Joseph can be contacted via phone (541) 504-9577.Contact Information
Primary practice address
676 Ne Negus Way
Redmond OR 97756-8527
Phone: (541) 504-9577
Fax: (541) 504-2361
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 02-11-74 | Oregon |
Profile Details
| NPI number | 1205973864 |
|---|---|
| LBN Legal business name | Smith, Roger Joseph |
| Credentials | CADC I |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 31st, 2007 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205973864 | NPPES |
| Oregon | MEDICAID | 210831 |
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