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Contact Information

JARED RUSSELL, PTA
421 S EVANS ST
MCMINNVILLE, OR97128
 Phone: 503-472-3141
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapy Assistant

225200000X
Indicates primary specialty

NPI Profile & details for JARED RUSSELL · (Male)

NPI # 1841690286
Status Active
Credentials PTA (Physical Therapist Assistant)
Entity Individual
Enumeration date 09/03/2014
Last updated 09/03/2014 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • OR License # 09077
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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