Provider Demographics
NPI:1699868620
Name:FRANCE, RUSSELL LINCOLN
Entity type:Individual
Prefix:MR
First Name:RUSSELL
Middle Name:LINCOLN
Last Name:FRANCE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14778 SE GARLAND LN
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97267-2950
Mailing Address - Country:US
Mailing Address - Phone:503-659-6751
Mailing Address - Fax:
Practice Address - Street 1:12100 SE STEVENS CT STE 106
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97266-8707
Practice Address - Country:US
Practice Address - Phone:503-353-7310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician