Individual
ANN M . RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
916 PACIFIC AVE 2ND FLOOR, EVERETT, WA 98201
(425) 303-6500
(425) 303-6550
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
(866) 366-2983
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
AP30005799
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9630906
—
WA
01
—
AB24828
MEDICARE
WA
Enumeration date
10/02/2006
Last updated
02/17/2015
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