BEN RUSSELL

PORTLAND, OR
NPI1174340525
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy175T00000X Peer Specialist
(Licence: OR  24-CRM-3712)
Enumeration Date2024-09-25
Last Update Date2024-09-25
Business Address
BEN RUSSELL
80 SE MADISON ST
PORTLAND, OR 97214-4527
Phone number: 916-584-5821
Mailing Address
BEN RUSSELL
620 SE 146TH AVE
PORTLAND, OR 97233-2507
Phone number: 971-380-0984