Individual
RUSSELL L SPIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 S 43RD ST, RENTON, WA 98055-5714
(428) 228-3450
Mailing address
PO BOX 24584, SEATTLE, WA 98124-0584
(425) 656-4255
(425) 656-4003
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
MD00025361
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
185268
LABOR&INDUSTRIES PROV #
WA
05
—
8304248
—
WA
01
—
SP5650
REGENCE B/S PROV #
WA
Enumeration date
08/31/2006
Last updated
06/21/2010
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