Individual
MARIA RAE RUSSELL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
TECHNICIAN
Contact information
Practice address
6939 COAL CREEK PKWY SE, NEWCASTLE, WA 98059-3136
(425) 644-4416
(425) 644-7427
Mailing address
1318 KIRKLAND AVE NE, RENTON, WA 98056-3217
(425) 277-8017
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
VA00022299
WA
Other
Enumeration date
12/08/2005
Last updated
07/08/2007
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