KELLY HANH RUSSELL (NPI# 1346591898) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1346591898 |
Entity Type | Individual |
Full Name | KELLY HANH RUSSELL |
Credential | PA-C |
Practice Address |
1375 N 10th Ave Stayton OR 97383 |
Mailing Address |
1375 N 10th Ave Stayton OR 97383-2099 |
Practice Telephone | 5037692641 |
Practice Fax Number | 5037693797 |
Mailing Telephone | 5037692641 |
Mailing Fax Number | 5037693797 |
Enumeration Date | 2012-09-24 |
Last Update Date | 2018-05-15 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326468729 | Kelly Russell | Counselor | 3415 Se Powell Blvd Trillium Family Services, Portland, OR 97202 | 2014-04-24 |
1376829838 | Kelly C Russell | Counselor | 24 Pleasant St Rear, Newburyport, MA 01950-2610 | 2011-10-28 |
1336244763 | Kelly Gravino Russell | Social Worker | 16 Bush Hill Rd, Ipswich, MA 01938-1642 | 2006-09-13 |
1154957652 | Kelly Russell | Advanced Practice Midwife | 101 Dudley St, Providence, RI 02905-2401 | 2020-03-16 |
1942770409 | Kelly Leonora Russell | Counselor | 611 12th Ave S, Seattle, WA 98144-2007 | 2018-11-27 |
1992179535 | Kelly Marie Spegel Russell | Psychologist | 1843 Rw Berends Dr Sw, Wyoming, MI 49519-4955 | 2015-11-19 |
1538375233 | Kelly Shannon Russell | Nurse Practitioner | 200 N Easton, Allen, OK 74825-9713 | 2007-05-16 |
1205816923 | Kelly Yvette Russell | Anesthesiology | 1850 N Central Ave, Ste1600, Phoenix, AZ 85004-4527 | 2006-01-19 |
Street Address |
1375 N 10TH AVE |
City | STAYTON |
State | OR |
Zip Code | 97383 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316940919 | Claire E King | Family Medicine | 1375 N 10th Ave, Suite B, Stayton, OR 97383-2099 | 2005-05-27 |
1932554680 | Katie Elizabeth Metzger | Physician Assistant | 1375 N 10th Ave, Stayton, OR 97383-2099 | 2016-05-02 |
1801255120 | Kelsey Marie Conklin | Registered Nurse | 1375 N 10th Ave, Stayton, OR 97383-2099 | 2016-02-15 |
1619341724 | Carl Wallace Leder | Physician Assistant | 1375 N 10th Ave, Stayton, OR 97383-2099 | 2015-12-01 |
1215306634 | Jennifer Rae Muller | Nurse Practitioner | 1375 N 10th Ave, Stayton, OR 97383-2099 | 2015-09-15 |
1790171874 | Santiam Memorial Hospital | Clinic/Center | 1375 N 10th Ave, Suite B, Stayton, OR 97383-2099 | 2015-04-15 |
1083943617 | Santiam Memorial Hospital | Clinic/Center | 1375 N 10th Ave, Suite B, Stayton, OR 97383-2037 | 2009-12-10 |
1912130915 | Stayton Family Practice Inc | Family Medicine | 1375 N 10th Ave, Stayton, OR 97383-2037 | 2009-08-25 |
1447491121 | Maria Margarita Turney | Nurse Practitioner | 1375 N 10th Ave, Suite B, Stayton, OR 97383-2099 | 2009-03-10 |
1659524494 | Stayton Family Practice LLC | Family Medicine | 1375 N 10th Ave, Stayton, OR 97383-2037 | 2008-10-24 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487204228 | Bishop Stayton Lessee LLC | Assisted Living Facility | Elmcroft of Stayton, 2201 3rd Ave., Stayton, OR 97383 | 2019-09-13 |
1972097699 | Nathan Daniel Hoover | Pharmacist | 1401 North 10th Ave, Stayton, OR 97383 | 2018-06-16 |
1801211560 | Maria A Fife | Nurse Practitioner | 1095 N 1st Ave, Stayton, OR 97383 | 2014-03-04 |
1467771295 | Jennifer Clorinda Brewer | Obstetrics & Gynecology | 1373 N. 10th Ave, Stayton, OR 97383 | 2010-05-18 |
1578785622 | Lakeside Cottages | Assisted Living Facility | #310-369 Wildflower Drive, Stayton, OR 97383 | 2007-05-02 |
1215099627 | Ritchie B Gooch | Family Medicine | 1377 N 10th Avenue, Stayton, OR 97383 | 2006-12-14 |
1710932710 | Promotion Advanced Functional Rehab LLC | Physical Therapy Assistant | 601 N 1st Ave, Stayton, OR 97383 | 2006-05-24 |
1508352279 | Madison Taylor Eymann | Physical Therapist | 1750 Wilco Rd, Stayton, OR 97383 | 2018-07-06 |
1154814390 | Santiam Memorial Hospital | Clinic/Center | 1371 N 10th Ave, Stayton, OR 97383 | 2018-06-12 |
1912413147 | Santiam Memorial Hospital | Clinic/Center | 1369 N 10th Ave, Stayton, OR 97383 | 2017-12-26 |
Find all providers in zip 97383 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932554680 | Katie Elizabeth Metzger | Physician Assistant | 1375 N 10th Ave, Stayton, OR 97383-2099 | 2016-05-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942808605 | Pilar Lorena Lopez | Physician Assistant | 7675 Sw Spruce St, Tigard, OR 97223-8723 | 2020-10-15 |
1730787615 | Michael Hisao Mun Ho Pang | Physician Assistant | 1245 Sw 160th Ave, Beaverton, OR 97006-5052 | 2020-10-13 |
1144834805 | Logan Michael Johnston | Physician Assistant | 3319 Edgeview Ln, Forest Grove, OR 97116-1094 | 2020-09-01 |
1285255851 | Darby Samantha Jalbert | Physician Assistant | 2480 Liberty St Ne Ste 110, Salem, OR 97301-8381 | 2020-05-05 |
1033751433 | Trisha K Loch | Physician Assistant | 781 W Central, Sutherlin, OR 97479 | 2019-10-17 |
1154805729 | Ronald William Strohmeyer | Physician Assistant | 2327 S.w. 4th Ave, Ontario, OR 97914 | 2018-09-19 |
1740797166 | Joseph Something | Physician Assistant | 4800 Sw 76th Ave, Portland, OR 97225-1804 | 2018-01-08 |
1235687013 | Satchel Harry | Physician Assistant | 417 Sw 117th Ave Fl 2, Portland, OR 97225-5924 | 2016-09-21 |
1093263386 | Megan Smith | Physician Assistant | 375 Park Ave Ste 5, Coos Bay, OR 97420 | 2016-09-14 |
1659828044 | Ryan Jones | Physician Assistant | 1775 Thompson Rd Bay Or97420, Coos Bay, OR 97420-2125 | 2016-09-02 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.