Provider Demographics
NPI:1821361502
Name:SMITH, LAURA ANN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ANN
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1175 MOUNT HOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WOODBURN
Mailing Address - State:OR
Mailing Address - Zip Code:97071-9060
Mailing Address - Country:US
Mailing Address - Phone:503-982-2000
Mailing Address - Fax:503-982-0660
Practice Address - Street 1:1175 MOUNT HOOD AVE
Practice Address - Street 2:
Practice Address - City:WOODBURN
Practice Address - State:OR
Practice Address - Zip Code:97071-9060
Practice Address - Country:US
Practice Address - Phone:503-982-2000
Practice Address - Fax:503-982-0660
Is Sole Proprietor?:No
Enumeration Date:2012-02-11
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0011904183500000X, 1835P0018X
ORRPH-0011904183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR0011904OtherSTATE PHARMACIST LICENSE