Individual
ALEX J RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1046 6TH AVE SW, ALBANY, OR 97321-1916
(541) 812-4000
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
10003648
OR
Other
Enumeration date
01/23/2023
Last updated
07/27/2023
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