Individual
JAMES M RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13519 SE 250TH ST, KENT, WA 98042-6635
(253) 631-9299
Mailing address
13519 SE 250TH ST, KENT, WA 98042-6635
(253) 631-9299
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD00011633
WA
Other
Enumeration date
05/29/2007
Last updated
07/08/2007
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