Individual
JEREMY JOSEPH RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
901 RAINIER AVE S, SEATTLE, WA 98144-2839
(206) 470-3880
(206) 470-3857
Mailing address
901 RAINIER AVE S, SEATTLE, WA 98144-2839
(206) 470-3880
(206) 470-3857
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/18/2019
Last updated
04/18/2019
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