Provider Demographics
NPI:1376817874
Name:JONES, RUSSELL DUANE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:DUANE
Last Name:JONES
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16625 SE 362ND DR
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:OR
Mailing Address - Zip Code:97055-9247
Mailing Address - Country:US
Mailing Address - Phone:503-668-2363
Mailing Address - Fax:503-668-2327
Practice Address - Street 1:16625 SE 362ND DR
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:OR
Practice Address - Zip Code:97055-9247
Practice Address - Country:US
Practice Address - Phone:503-668-2363
Practice Address - Fax:503-668-2327
Is Sole Proprietor?:No
Enumeration Date:2012-02-29
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR12295183500000X
OR00122951835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist