Individual
CHRISSIE COLLETTE RUSSELL-WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
501 SE 172ND AVE STE 130, VANCOUVER, WA 98684
(360) 882-2778
(360) 604-1772
Mailing address
PO BOX 4825, PORTLAND, OR 97208-4825
(360) 882-2778
(360) 604-1771
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP30007938
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1079961
—
WA
Enumeration date
12/20/2007
Last updated
10/28/2019
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