Individual
MR. RUSSELL MIKAMI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
618 N SULLIVAN RD, SUITE 3, SPOKANE VALLEY, WA 99037-8528
(509) 928-3443
(509) 891-5591
Mailing address
618 N SULLIVAN RD, SUITE 3, SPOKANE VALLEY, WA 99037-8528
(509) 928-3443
(509) 891-5591
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
025208 PT00003614
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7107627
—
WA
Enumeration date
01/06/2006
Last updated
08/13/2010
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