Individual
JESSICA ELLEN LEVONN RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DH
Contact information
Practice address
626 2ND AVE S, OKANOGAN, WA 98840
(509) 422-5700
Mailing address
PO BOX 1340, OKANOGAN, WA 98840-1340
(509) 422-5700
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH00007140
WA
Other
Enumeration date
05/25/2018
Last updated
05/25/2018
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