Individual
DON R RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1910 S MERIDIAN, SUITE A, PUYALLUP, WA 98371-7531
(253) 848-2303
(253) 848-8956
Mailing address
1910 S MERIDIAN, SUITE A, PUYALLUP, WA 98371-7531
(253) 848-2303
(253) 848-8956
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
OPOOOOO811
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1819200
—
WA
Enumeration date
07/24/2006
Last updated
01/07/2014
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