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NPI Code Detail

MEDICARE: DR. YELIZAVETA RUSS PHARM.D.

MEDICARE: DR. YELIZAVETA RUSS PHARM.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist050511NY

General Provider Information

NPI Number : 1588679278
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. YELIZAVETA RUSS PHARM.D.
Provider Business Mailing Address
First Line : 305 SW EDGEWAY DR APT 407
Second Line :
City : BEAVERTON
State : OR
Zip : 97006-3555
Country : US
Telephone Number : 503-690-0351
Fax Number : 801-340-0165
Provider Business Practice Location Address
First Line : 3710 SW US VETERANS HOSPITAL RD
Second Line :
City : PORTLAND
State : OR
Zip : 97239-2964
Country : US
Telephone Number : 503-220-8262
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2006
Last Update Date : 03/17/2026

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