Provider Demographics
NPI:1841400850
Name:ALLBUTTER LLC
Entity Type:Organization
Organization Name:ALLBUTTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:B
Authorized Official - Last Name:RUSS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-754-6136
Mailing Address - Street 1:7928 SE MADISON ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97215-3021
Mailing Address - Country:US
Mailing Address - Phone:503-754-6136
Mailing Address - Fax:503-221-5454
Practice Address - Street 1:1020 SW TAYLOR ST
Practice Address - Street 2:#330
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2543
Practice Address - Country:US
Practice Address - Phone:503-754-6136
Practice Address - Fax:503-221-5454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3117261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty