JACQUELINE MARIE RUSSELL

ENTERPRISE, OR
NPI1720673577
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: OR  10013334)
Enumeration Date2021-03-03
Last Update Date2024-03-01
Business Address
JACQUELINE MARIE RUSSELL PMHNP-BC
606 MEDICAL PKWY
ENTERPRISE, OR 97828-5140
Phone number: 541-426-4524
Mailing Address
JACQUELINE MARIE RUSSELL PMHNP-BC
79571 LEAP LN
WALLOWA, OR 97885-7107
Phone number: 503-899-3219
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