Individual
RUSSELL K DORER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD,PHD
Taxonomy
Speciality
Code
Description
License number
State
207ZC0006X
Clinical Pathology Physician
MD00046178
WA
207ZP0101X
Anatomic Pathology Physician
Primary
MD00046178
WA
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
MD00046178
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039575
L&I
WA
01
—
5949DO
BLUE SHIELD
WA
01
—
7972795
AETNA
WA
05
—
8463630
—
WA
Enumeration date
07/21/2006
Last updated
02/25/2025
Update your record
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