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General NPI Number Information
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NPI Number | 1376817874
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Entity Type | Individual
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Provider Name | RUSSELL DUANE JONES PHARMD
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Gender | Male
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Dates
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Enumeration Date | 02/29/2012
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Last Update Date | 04/26/2017
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Provider Practice Location Address
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Address Line | 16625 SE 362ND DR
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City | SANDY
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State | OR
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Zip | 97055-9247
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Country | US
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Telephone | 503-668-2363
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Fax | 503-668-2327
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Provider Business Mailing Address
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Address Line | 16625 SE 362ND DR
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City | SANDY
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State | OR
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Zip | 97055-9247
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Country | US
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Telephone | 503-668-2363
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Fax | 503-668-2327
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 12295
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 0012295
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License Number State | OR
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