Individual
BRIAN RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
751 NE BLAKEY DRIVE, SWEDISH MEDICAL CENTER, ISSAQUAH, WA 98027
(425) 394-0610
Mailing address
2005 NW SAMMAMISH RD, ISSAQUAH, WA 98027-8940
(425) 394-0600
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
60310413
WA
Other
Enumeration date
10/19/2012
Last updated
11/06/2021
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