Individual
MRS. JUDITH G RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
THERAPIST
Contact information
Practice address
6313 NE 109TH ST, VANCOUVER, WA 98686-4631
(360) 718-7119
Mailing address
6313 NE 109TH ST, VANCOUVER, WA 98686-4631
(360) 718-7119
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
RC 00044340
WA
174400000X
Specialist
RC00044340
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RC 00044340
REGISTERED COUNSELOR
WA
Enumeration date
10/21/2008
Last updated
10/21/2008
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