Individual
MR. JAMES DOUGLAS RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
4531 SE BELMONT ST, PORTLAND, OR 97215-1675
(503) 215-6556
Mailing address
4531 SE BELMONT ST, PORTLAND, OR 97215-1675
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
081003217RN
OR
Other
Enumeration date
09/14/2012
Last updated
09/14/2012
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