Smith, Russell Dale

Smith, Russell Dale is an sole proprietor health care provider with primary practice located at 309 Elm Ave , Tillamook OR 97141-3437. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist, which is considered as his primary health care specialty. Smith, Russell Dale can be contacted via phone (503) 812-4435.

Contact Information

Primary practice address
309 Elm Ave Tillamook OR 97141-3437
Phone: (503) 812-4435
Fax: (503) 842-0396
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist 225700000X 15176 Oregon

Profile Details

NPI number 1477852580
LBN Legal business name Smith, Russell Dale
Credentials LMT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 16th, 2011
Last updated Jan 28th, 2012 - about 14 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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