Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Shane Smedley, QMHA-R, CRM, PSS-AD

Individual provider Peer Specialist · NPI 1710672449

Mr. Shane Smedley, QMHA-R, CRM, PSS-AD is a Peer Specialist in Shady Cove, Oregon. Practices as a sole proprietor. Licensed in Oregon.

Licensed in
OR
In the registry since
2023

Practice location Address checks out

361 Yewwood Dr
Shady Cove, OR 97539-9794
Phone: (458) 204-8226
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Peer Specialist (primary) Taxonomy 175T00000X · Licence 108144 (OR)

Record details

NPI number1710672449
Entity typeIndividual (Type 1)
GenderMale
Credentials QMHA-R , CRM , PSS-AD
Sole proprietorYes
NPI enumeratedApril 10, 2023
Last updated in NPPESSeptember 11, 2025
Certification dateJune 30, 2023