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Individual

MRS. BRENDA DARLENE RUSSELL-HOSPENTHAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMP

Contact information

Practice address
11216 SUNRISE BLVD E, SUITE 3-203, PUYALLUP, WA 98374-8848
(253) 864-6519
Mailing address
11216 SUNRISE BLVD E, SUITE 3-203, PUYALLUP, WA 98374-8848
(253) 864-6519

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00009642
WA

Other

Enumeration date
01/30/2007
Last updated
04/11/2011
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