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1881056109
TRACEY MARIE RUSS
SALEM, OR
NPI
1881056109
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
302R00000X Health Maintenance Organization
(Licence: CO 0012073)
Enumeration Date
2016-03-25
Last Update Date
2016-03-25
Business Address
Ms. TRACEY MARIE RUSS PTA
3445 BOONE RD SE
SALEM, OR 97317-9336
Phone number: 503-576-3000
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Mailing Address
Ms. TRACEY MARIE RUSS PTA
33815 SE PEORIA ROAD
CORVALLIS, OR 97333
Phone number: 720-352-6745
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