MR. Jonathan Forrest Russell, PA

NPI #1396934196 in Winston, Oregon

Provider Information

NPI Number: 1396934196
Entity Type: Individual
Name: MR. Jonathan Forrest Russell, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Oct 17, 2007
Last Updated: Mar 5, 2025

Practice Location

Address: 671 SW MAIN ST
City: Winston
State: Oregon
ZIP Code: 97496-6571
Phone: (541) 492-4550

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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