Individual
BONNIE RUSSELL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
840 E PLUM, MOSES LAKE, WA 98837
(509) 765-9239
(509) 765-1582
Mailing address
715 S HAWTHORNE DR, MOSES LAKE, WA 98837-1842
(509) 765-9239
(509) 765-1582
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
RC00053993
WA
Other
Enumeration date
06/08/2006
Last updated
07/08/2007
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