Individual
CHRIS BRUSSOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7425 WRIGLEY DR STE 100, PASCO, WA 99301-5292
(509) 416-8888
Mailing address
1501 KINGS HIGHWAY, FAMILY MEDICINE, SHREVEPORT, LA 71130
(318) 626-0014
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD61138389
WA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/16/2018
Last updated
07/15/2021
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