Provider Demographics
NPI:1982881181
Name:SMITH, DARRON TERRY (PHD, PA-C, DFAAPA)
Entity type:Individual
Prefix:DR
First Name:DARRON
Middle Name:TERRY
Last Name:SMITH
Suffix:
Gender:M
Credentials:PHD, PA-C, DFAAPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 SW YAMHILL ST STE 300
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97204-3316
Mailing Address - Country:US
Mailing Address - Phone:503-523-0296
Mailing Address - Fax:971-297-1360
Practice Address - Street 1:914 MAIN ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-3136
Practice Address - Country:US
Practice Address - Phone:503-878-8885
Practice Address - Fax:971-297-1360
Is Sole Proprietor?:No
Enumeration Date:2008-01-30
Last Update Date:2025-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2943363A00000X
ORPA222670363A00000X
UT326942-1206363A00000X
WAPA61505796363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA57494OtherPHYSICIAN ASSISTANT BOARD