# RUSSELL A. BARRON, DDS, INC, PS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558485219
- **Authorized official:** RUSSELL ALLEN BARRON DDS (CEO)
- **Authorized official phone:** (360) 629-2420

## Contact information

- **Practice address:** 9619 271ST ST NW, STANWOOD, WA 98292-0819
- **Practice address phone:** (360) 629-2420
- **Practice address fax:** (360) 629-7211
- **Mailing address:** PO BOX 819, STANWOOD, WA 98292-0819
- **Mailing address phone:** (360) 629-2420
- **Mailing address fax:** (360) 629-7211

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DE00003899 | WA | Yes |

## Other

- **Enumeration date:** 03/19/2007
- **Last updated:** 11/19/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0151502 | L & I REGULAR PROVIDER \# | WA |
| 05 | — | 5320205 | — | WA |
| 05 | — | 8004236 | — | WA |
| 01 | — | 8924064 | L & I CRIME VICTIMS PROV\# | WA |