Individual
RUSSELL HYSLOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11104 NE 149TH ST, BRUSH PRAIRIE, WA 98606-9565
(360) 389-7588
Mailing address
11217 NW 25TH CT, VANCOUVER, WA 98685-4421
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
11/15/2021
Last updated
11/15/2021
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