Tammy Lee Russell MS, RD

NPI 1073701058 - Dietitian, Registered - 133V00000X

NPI Details
NPI 1073701058
Gender Female
Enumeration Date 10/04/2007
Last Updated 10/04/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
163 NE 102ND AVE BLDG 5
PORTLAND OR, 97220-4169, US
Phone (503) 257-3326
Fax
Business Location
11438 SW OAK CREEK DR
PORTLAND OR, 97219-8943, US
Phone (502) 244-0829
Fax
Toxanomy
Taxonomy Code 133V00000X
License State Oregon
License Number 833
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According to our database, Mrs. Tammy Lee Russell MS, RD NPI is 1073701058, taxonomy code is 133V00000X and license number is 833, license state is located at Oregon. Tammy Lee Russell MS, RD physically located at 163 Ne 102nd Ave Bldg 5, Portland OR, 97220-4169. NPI Number Tammy Lee Russell MS, RD has the Individual type.

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1073701058 NPI number is provided on an as is basis without warranty of any kind. 1073701058 is maintained by the National Plan & Provider Enumeration System. The contents of Tammy Lee Russell MS, RD are for informational purposes only.