Provider Demographics
NPI:1841817541
Name:SMITH, ADELE E (RNFA)
Entity type:Individual
Prefix:MRS
First Name:ADELE
Middle Name:E
Last Name:SMITH
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4103 MERCANTILE DR
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-2556
Mailing Address - Country:US
Mailing Address - Phone:360-852-3900
Mailing Address - Fax:
Practice Address - Street 1:4103 MERCANTILE DR
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-2556
Practice Address - Country:US
Practice Address - Phone:503-850-9940
Practice Address - Fax:503-850-6709
Is Sole Proprietor?:No
Enumeration Date:2020-06-29
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201242812RN163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant