| Doctor Name: | DR. JENNIFER RUSSELL |
| NPI Number: | 1164850137 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DVM |
| License Number: | 5806 |
| Business Practice Address: | 3501 Evergreen Way Washougal, WA - 986719142 |
| Business Phone Number: | 3608352184 |
| Business Fax Number: | 3608352186 |
| Mailing Address: | 3501 Evergreen Way, WASHOUGAL |
| State: | WA |
| Postal Code: | 986719142 |
| Phone Number: | 3608352184 |
| Fax Number: | 3608352186 |
| NPI Enumeration Date: | 10/29/2013 |
| NPI Last Update Date: | 10/29/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174M00000X |
| License Number: | 5806 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OR |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Veterinarian |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A doctor of veterinary medicine, trained and authorized to practice veterinarian medicine and surgery. |