Individual
ANTHONY R RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6903 OAKMONT AVE SE, SNOQUALMIE, WA 98065-8716
(425) 999-6127
Mailing address
6903 OAKMONT AVE SE, SNOQUALMIE, WA 98065-8716
(425) 999-6127
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
RC60069117
WA
Other
Enumeration date
11/20/2009
Last updated
11/20/2009
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