Individual
AMY RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1415 E 72ND ST STE B, TACOMA, WA 98404-5905
(253) 300-7474
Mailing address
1700 AIRPORT WAY S, SEATTLE, WA 98134-1618
(206) 223-3644
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60556004
WA
Other
Enumeration date
11/01/2018
Last updated
10/17/2025
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