Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | NT.60588766 | WA |
NPI | 1003287483 |
---|---|
Provider Name | Dr. Maria Camille Russell |
First Address | Seattle, WA 98115-2649 |
Second Address | Seattle, WA 98103-8004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2015 |
Last Update Date | 12/10/2015 |