Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 4301085810 | MI |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | MD26633 | OR |
NPI | 1699855437 |
---|---|
Provider Name | Dr. Dana Sainsbury Smith |
First Address | Clackamas, OR 97015-9777 |
Second Address | Clackamas, OR 97015-9777 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 04/02/2022 |