Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MS. TRACEY MARIE RUSS, PTA
Active Sole ProprietorMS. TRACEY MARIE RUSS, PTA is a Health Maintenance Organization healthcare provider located in SALEM, Oregon. NPI 1881056109 is currently active in the NPPES registry. Verify at CMS.
Health Maintenance Organization · SALEM, OR
Registration Details
- NPI Number
- 1881056109
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Mar 25, 2016 (10.423478930566 yrs)
- Last Updated
- Mar 25, 2016
- License
-
0012073 (CO)
- Sole Proprietor
- Yes
Practice Information
- Address
-
3445 BOONE RD SESALEM, OR, 973179336Browse OR providers · Browse ZIP 97317
- Phone
- 5035763000
- Primary Specialty
-
Health Maintenance Organization
302R00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.