Individual
VANDA MARION RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
855 AARON DR, LYNDEN, WA 98264-9396
(360) 354-4434
Mailing address
5056 FESTIVAL BLVD APT A, BELLINGHAM, WA 98226-7610
(360) 734-7177
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
908
WA
Other
Enumeration date
03/25/2012
Last updated
03/25/2012
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