Individual
JENNIFER LYNN RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L M T
Contact information
Practice address
9621 MICKELBERRY RD NW STE 108, SILVERDALE, WA 98383-8301
(360) 692-5350
(360) 692-5354
Mailing address
9621 MICKELBERRY RD NW STE 108, SILVERDALE, WA 98383-8301
(360) 692-5350
(360) 692-5354
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00020164
WA
Other
Enumeration date
07/07/2008
Last updated
03/21/2024
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