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Individual

MICHAEL RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
217 W CATALDO AVE FL 3, SPOKANE, WA 99201-2217
(509) 747-6194
(509) 227-7070
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD61451324
WA

Other

Enumeration date
03/06/2019
Last updated
08/13/2024
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