Individual
TRACY LYNNE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
611 N F ST, STE 201, ABERDEEN, WA 98520-2667
(360) 533-7677
(360) 533-0470
Mailing address
611 N F ST, STE 201, ABERDEEN, WA 98520-2667
(360) 533-7677
(360) 533-0470
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD00046873
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1123256
—
WA
Enumeration date
02/02/2006
Last updated
07/19/2011
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