Provider Demographics
NPI:1013376078
Name:LAKEY-SMITH, JEANNE EVELYN (CSWA)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:EVELYN
Last Name:LAKEY-SMITH
Suffix:
Gender:F
Credentials:CSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 VILLA RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-1851
Mailing Address - Country:US
Mailing Address - Phone:503-538-4874
Mailing Address - Fax:
Practice Address - Street 1:504 VILLA RD
Practice Address - Street 2:SUITE 3
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-1851
Practice Address - Country:US
Practice Address - Phone:503-538-4874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-18
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator