Doctor Name: | MRS. TAMMY LEE RUSSELL |
NPI Number: | 1073701058 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, RD |
License Number: | 833 |
Business Practice Address: | 163 Ne 102nd Ave Bldg 5 Portland, OR - 972204169 |
Business Phone Number: | 5032573326 |
Business Fax Number: | |
Mailing Address: | 11438 Sw Oak Creek Dr, PORTLAND |
State: | OR |
Postal Code: | 972198943 |
Phone Number: | 5022440829 |
Fax Number: | |
NPI Enumeration Date: | 10/04/2007 |
NPI Last Update Date: | 10/04/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 833 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |