Individual
JENNIFER RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2802 BROADWAY, EVERETT, WA 98201-3642
(425) 259-3191
Mailing address
6242 PELICAN RIDGE WAY, LEAGUE CITY, TX 77573
(509) 240-3566
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904017993
VA
Other
Enumeration date
07/07/2016
Last updated
06/30/2025
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