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1093983959
STEPHANIE ALICE RUSSELL
YAKIMA, WA
NPI
1093983959
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: WA 987692)
Enumeration Date
2008-02-13
Last Update Date
2008-02-13
Business Address
-- STEPHANIE ALICE RUSSELL RD, CD
808 N 39TH AVE
YAKIMA, WA 98902-6388
Phone number: 509-574-3408
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Mailing Address
-- STEPHANIE ALICE RUSSELL RD, CD
808 N 39TH AVE
YAKIMA, WA 98902-6388
Phone number:
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