Organization
METASEQUOIA EMERGENCY PHYSICIANS, LLC
Active
Organization
METASEQUOIA EMERGENCY PHYSICIANS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL H HARRIS (OFFICER)
(469) 401-2386
Entity
Organization
Contact information
Practice address
94220 4TH ST, GOLD BEACH, OR 97444-7756
(469) 401-2386
Mailing address
PO BOX 99029, LAS VEGAS, NV 89193-9029
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
07/28/2016
Last updated
08/02/2016
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