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Organization

COUNTY OF JEFFERSON

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KATHRINE RUSSELL MPH (DIRECTOR)
(541) 475-4456
Entity
Organization

Contact information

Practice address
500 NE A ST STE 102, MADRAS, OR 97741-1842
(541) 475-4456
(541) 475-0132
Mailing address
500 NE A ST STE 102, MADRAS, OR 97741-1842
(541) 475-4456
(541) 475-0132

Taxonomy

Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
CH-0000017
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
043070
OR
05
096776
OR
05
320424
OR
Enumeration date
02/14/2008
Last updated
09/08/2025
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