Individual
CHRISTY MARIE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
908 5TH AVE SE, OLYMPIA, WA 98501-1507
(360) 878-4809
Mailing address
503 V ST SE, TUMWATER, WA 98501-5347
(360) 995-3585
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
Primary
CG61325552
WA
Other
Enumeration date
11/18/2020
Last updated
08/02/2022
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