TRACEY MARIE RUSS

SALEM, OR
NPI1881056109
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy302R00000X Health Maintenance Organization
(Licence: CO  0012073)
Enumeration Date2016-03-25
Last Update Date2016-03-25
Business Address
MS. TRACEY MARIE RUSS PTA
3445 BOONE RD SE
SALEM, OR 97317-9336
Phone number: 503-576-3000
Mailing Address
MS. TRACEY MARIE RUSS PTA
33815 SE PEORIA ROAD
CORVALLIS, OR 97333
Phone number: 720-352-6745
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