Individual
RUSS K REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RT
Taxonomy
Speciality
Code
Description
License number
State
2471C3402X
Radiography Radiologic Technologist
Primary
RT00003044
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7015290
—
WA
Enumeration date
01/31/2007
Last updated
01/08/2008
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