Provider Demographics
NPI:1720489644
Name:SMITH, ASHLEIGH LAUREN (RN)
Entity Type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:LAUREN
Last Name:SMITH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1716 SE TAGGART ST
Mailing Address - Street 2:APT A
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-2275
Mailing Address - Country:US
Mailing Address - Phone:808-780-2709
Mailing Address - Fax:
Practice Address - Street 1:1716 SE TAGGART ST
Practice Address - Street 2:APT A
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-2275
Practice Address - Country:US
Practice Address - Phone:808-780-2709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-10
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60215136163W00000X
OR201140355RN163W00000X
OR201700540CRNA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty