Individual provider · Type 1 NPI

Justin Jake Russell, L.M.P.

Specialist · Leavenworth, WA

NPI number 1003092594 Active

Practice location

22470 Humphrey Dr
Leavenworth, WA 98826-9240

Call (253) 389-7510 Map

Mailing address

PO Box 475
Leavenworth, WA 98826-0475

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000XMA00024875 (WA)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1003092594

Justin Jake Russell, L.M.P.'s National Provider Identifier is 1003092594, issued on Jan 14, 2008. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Leavenworth, WA. The record was last updated on Aug 14, 2008.