Individual
MS. MARY CATHERINE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3710 SW US VETERANS HOSP RD, PORTLAND, OR 97207
(503) 220-8262
(503) 721-1070
Mailing address
2233 NE 41ST AVE, PORTLAND, OR 97212-5412
(503) 220-8262
(503) 721-1070
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
20050116
OR
Other
Enumeration date
12/21/2006
Last updated
07/08/2007
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