Pearl, Russell

Pearl, Russell is an sole proprietor health care provider with primary practice located at 1460 G St , Springfield OR 97477-4112. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Pearl, Russell can be contacted via phone (541) 726-4510.

Contact Information

Primary practice address
1460 G St Springfield OR 97477-4112
Phone: (541) 726-4510
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X PA10005135 Washington
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA01307 Oregon

Profile Details

NPI number 1962559567
LBN Legal business name Pearl, Russell
Credentials PA C
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 4th, 2007
Last updated May 21st, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962559567 NPPES
Washington Other 0216544 LIWA
Washington Other 3454PE LIWA
Washington MEDICAID 8471328 LIWA
Washington Other P91043 LIWA
Washington Other PEA1967 LIWA

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