Individual
KAREN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1375 NW MALL ST STE 4, ISSAQUAH, WA 98027-8950
(425) 654-0800
Mailing address
16705 SE 43RD ST, BELLEVUE, WA 98006-7141
(861) 942-5681
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/27/2021
Last updated
09/27/2021
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