# RUSS REYNOLDS

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

## Provider details

- **NPI number:** 1821268855
- **Authorized official:** MR. RUSS K REYNOLDS RT (OWNER)
- **Authorized official phone:** (509) 884-0602

## Contact information

- **Practice address:** 220 25TH ST NE, EAST WENATCHEE, WA 98802-4097
- **Practice address phone:** (509) 884-0602
- **Practice address fax:** (509) 884-0602
- **Mailing address:** 220 25TH ST NE, EAST WENATCHEE, WA 98802-4097
- **Mailing address phone:** (509) 884-0602
- **Mailing address fax:** (509) 884-0602

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | RT00003044 | WA | Yes |

## Other

- **Enumeration date:** 03/05/2008
- **Last updated:** 11/26/2013