Individual
ELISE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 24TH AVE S, SEATTLE, WA 98144-4637
(206) 382-5340
Mailing address
2100 24TH AVE S, SEATTLE, WA 98144-4637
(206) 382-5340
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
WA
Other
Enumeration date
03/01/2024
Last updated
11/12/2025
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