Mauricio Smith, CHW

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

114711 Issued in OR

Practice address

608 Lancaster Dr SE
Salem, OR 97317-5643

Phone

(503) 877-1995

Fax

(888) 990-1352

NPI assigned

Aug 28, 2025

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1756339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1194604637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 LANCASTER DR SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973175643",
            "telephone_number": "503-877-1995",
            "fax_number": "888-990-1352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 LANCASTER DR SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973175643",
            "telephone_number": "503-877-1995",
            "fax_number": "888-990-1352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MAURICIO",
        "credential": "CHW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-28",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "OR",
            "license": "114711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karla Raye Olsen Smith, R.D.H.
• Kate Smith, PSS
• Kayla Smith
• Kristen Marie Smith, DMD
• Lauren Nicole Smith
• Michael Patrick Smith, DNP, FNP-C
• Monique B. Smith, CADC-R
• Nikki Smith, PTA
• Pamela P Smith, MD
• Robert Alexander Smith, QMHA

• Community Health Worker in Salem, OR
• Providers in Salem, OR by specialty
• Community Health Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.