Provider Demographics
NPI:1992810659
Name:SMART, KARI LYN (MD)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:LYN
Last Name:SMART
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:LYN
Other - Last Name:KOIVISTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:700 N DEBORAH RD STE 150
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-2198
Mailing Address - Country:US
Mailing Address - Phone:503-554-0549
Mailing Address - Fax:
Practice Address - Street 1:700 N DEBORAH RD STE 150
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-2198
Practice Address - Country:US
Practice Address - Phone:503-554-0549
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00037847208000000X
ORMD20913208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics