Individual
MISS ERIN MICHELLE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2333 PACIFIC AVE, FOREST GROVE, OR 97116-2449
(503) 359-6145
(503) 359-6919
Mailing address
6021 NE BIRCH ST, HILLSBORO, OR 97124-7262
(503) 880-2115
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-AT-299979
OR
Other
Enumeration date
07/26/2006
Last updated
09/10/2007
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