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1629061981
THERESA A RUSSELL
ENTERPRISE, OR
NPI
1629061981
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner Family
(Licence: OR 91000286)
Enumeration Date
2005-08-23
Last Update Date
2013-12-13
Business Address
THERESA A RUSSELL FNP
406 NE 1ST ST
ENTERPRISE, OR 97828-1168
Phone number: 541-426-4502
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Mailing Address
THERESA A RUSSELL FNP
406 NE 1ST ST
ENTERPRISE, OR 97828-1168
Phone number: 541-426-4502
Copy
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