Individual ProviderParrish SmithPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011(503) 494-7660PECOS EnrollmentBased on the most recent information from CMS, provider Parrish Smith is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1457635732Provider TypeIndividualFull NameSmith, ParrishCredentialPA-CGenderFemaleSole ProprietorNoEnumeration Date10/4/2011Last Updated7/14/2023Contact InformationPractice LocationPractice Address3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011Phone(503) 494-7660FaxUnlisted FaxMailing LocationMailing Address3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011Phone(503) 494-7660FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363AM0700XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicensePA192419OregonCode363A00000XDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicense055.0031167VermontCode363A00000XDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicense0010-08485North CarolinaCode363AM0700XDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicenseTL1722South CarolinaProvider IdentifiersIDDescriptionIssuerID1288PADescriptionMedicaidIssuerUnlistedSouth Carolina