Individual
MATTHEW FRANKLIN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1415 E KINCAID ST, MOUNT VERNON, WA 98274-4126
(360) 428-2166
(360) 428-2457
Mailing address
505 S 336TH ST, SUITE # 600, FEDERAL WAY, WA 98003-6328
(360) 428-2166
(253) 838-6418
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0182293
LIWA
WA
01
—
7458RU
BSWA
WA
05
—
8283186
—
WA
Enumeration date
06/30/2006
Last updated
02/22/2008
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