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Individual

ROBERT M. RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
330 S STILLAGUAMISH AVE, ARLINGTON, WA 98223-1642
(360) 435-2133
Mailing address
505 S 336TH ST STE 600, FEDERAL WAY, WA 98003-5947
(425) 971-1866

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD00016164
WA
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
MD00016164
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8151409
WA
Enumeration date
05/10/2006
Last updated
08/23/2010
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