Russell, Kraig M

Russell, Kraig M is an individual health care provider with primary practice located at 10123 Se Market St , Portland OR 97216-2532. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine. Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine is his primary health care specialty. Russell, Kraig M can be contacted via phone (503) 261-6985.

Contact Information

Primary practice address
10123 Se Market St Portland OR 97216-2532
Fax: (503) 261-6790
Website:

Health care specialties

Profile Details

NPI number 1760414916
LBN Legal business name Russell, Kraig M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2006
Last updated Feb 4th, 2022 - about 4 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 1760414916 NPPES
Ohio MEDICAID 2663069
Ohio MEDICAID 5911521

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