Individual
CARA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
15675 AMBAUM BLVD SW, BURIEN, WA 98166-2523
(206) 631-3000
Mailing address
3599 E E ST APT 2, TACOMA, WA 98404-2171
(253) 282-5930
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
60663906
WA
Other
Enumeration date
10/24/2016
Last updated
10/24/2016
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