Individual
RUSSELL S VALENTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
220 S 38TH ST, TACOMA, WA 98418-7847
(253) 475-4631
(253) 475-2635
Mailing address
220S 38TH ST, TACOMA, WA 98418-7807
(253) 475-4631
(253) 475-2635
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7290
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
846654
UNITED CONCORDIA
WA
Enumeration date
03/27/2006
Last updated
11/24/2015
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