Individual
MRS. TAMMY LEE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
1820 SW VERMONT ST STE F, PORTLAND, OR 97219-1945
(503) 313-6778
Mailing address
1820 SW VERMONT ST STE F, PORTLAND, OR 97219-1945
(503) 313-6778
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
833
OR
Other
Enumeration date
10/04/2007
Last updated
10/16/2019
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