Justin Jake Russell, L.M.P.
NPI #1003092594 in Leavenworth, Washington
Provider Information
- NPI Number
- 1003092594
- Entity Type
- Individual
- Name
- Justin Jake Russell, L.M.P.
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Specialist
- Credential
- L.M.P.
- Enumeration Date
- Jan 14, 2008
- Last Updated
- Aug 14, 2008
Practice Location
- Address
- 22470 HUMPHREY DR
- City
- Leavenworth
- State
- Washington
- ZIP Code
- 98826-9240
- Phone
- (253) 389-7510
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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