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Individual

TAMARA LYNNE RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSYD

Contact information

Practice address
4441 DIPLOMACY DR, ANCHORAGE, AK 99508-5910
(907) 729-8880
Mailing address
7033 E TUDOR RD, ANCHORAGE, AK 99507-1262
(907) 729-6799
(907) 729-5180

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSYP667
AK
103TC0700X
Clinical Psychologist
PY00003727
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8483430
WA
Enumeration date
05/30/2006
Last updated
10/02/2024
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