THERESA A RUSSELL

ENTERPRISE, OR
NPI1629061981
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: OR  91000286)
Enumeration Date2005-08-23
Last Update Date2013-12-13
Business Address
-- THERESA A RUSSELL FNP
406 NE 1ST ST
ENTERPRISE, OR 97828-1168
Phone number: 541-426-4502
Mailing Address
-- THERESA A RUSSELL FNP
406 NE 1ST ST
ENTERPRISE, OR 97828-1168
Phone number: 541-426-4502
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