Individual
BRIAN JOSEPH RUSSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.P.T.ATC
Contact information
Practice address
14841 179TH AVE SE, SUITE 340, MONROE, WA 98272-1161
(360) 794-7520
(360) 794-8947
Mailing address
14841 179TH AVE SE, SUITE 340, MONROE, WA 98272-1161
(360) 794-7520
(360) 794-8947
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00007754
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7116288
—
WA
Enumeration date
06/22/2005
Last updated
07/08/2007
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