Individual
TAMARA LYNNE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
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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