Individual
JENNA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, CLT
Contact information
Practice address
39 SHORTCUT RD, INCHELIUM, WA 99138
(509) 722-7064
Mailing address
PO BOX 242, INCHELIUM, WA 99138-0242
(509) 808-9074
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT61562602
WA
Other
Enumeration date
09/23/2024
Last updated
03/17/2026
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