Individual
MRS. CHRYSTAL ANN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
4455 NE HIGHWAY 20, CORVALLIS, OR 97330-9695
(541) 758-5900
Mailing address
26841 BELLFOUNTAIN RD, MONROE, OR 97456-9755
(541) 230-4303
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/23/2007
Last updated
07/08/2007
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