Individual
RUSSELL WILLIAM ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
12 S 8TH ST, YAKIMA, WA 98901-3020
(509) 454-4143
(509) 454-3651
Mailing address
224 36TH ST, BELLINGHAM, WA 98225-6540
(360) 746-0946
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE60035251
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5057492
—
WA
Enumeration date
08/12/2008
Last updated
11/23/2015
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