RUSSELL J. KEIZER MD PC
Ambulatory Health at Exchange St, Tongue Point, OR

License number
Oregon MD08049
Category
Ambulatory Health
Type
Clinic/Center
Owner
Name: LINDA KEIZER
Title: OFFICE MANAGER
Phone: (503) 325-2448
Address
Address
2120 Exchange St #203, Tongue Point, OR 97103
National Provider ID: 1225072945
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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RUSSELL J. KEIZER, M.D., PC

Tongue Point, OR  -  Warrenton, OR

Registration:
Jun 30, 1976
Addresses:
PO Box 508, Astoria, OR 97103 (Mailing)
90016 Manion Dr, Warrenton, OR 97146 (Physical)
State ID:
11599818
Business type:
DOMESTIC PROFESSIONAL CORPORATION
Agent:
Harold Snow,801 Commercial St, Astoria, OR 97103 (Physical)

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