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1750507166
CARISSA L RUSSELL
OTHELLO, WA
NPI
1750507166
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
124Q00000X Dental Hygienist
(Licence: WA DH00006949)
Enumeration Date
2007-04-17
Last Update Date
2007-07-08
Business Address
Ms. CARISSA L RUSSELL RDH
140 E MAIN STREET
OTHELLO, WA 99344
Phone number: 509-488-5256
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Mailing Address
Ms. CARISSA L RUSSELL RDH
140 E MAIN STREET
OTHELLO, WA 99344
Phone number: 509-488-5256
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