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TRACY LYNNE RUSSELL MD NPI 1629040894


NPI Information

NPI: 1629040894
Provider Name: TRACY LYNNE RUSSELL, MD
Classification: Pediatrics - 208000000X
Entity Type: Individual
Address:
611 N F ST
STE 201
ABERDEEN, WA
ZIP 98520
Phone: (360) 533-7677
Get Directions

Tracy Lynne Russell, MD is a pediatrics in Aberdeen, WA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. Tracy Lynne Russell, MD NPI is 1629040894. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

611 N F ST
STE 201
ABERDEEN, WA
ZIP 98520-667
Phone: (360) 533-7677
Fax: (360) 533-0470

The enumeration date for this NPI number is 2/2/2006 and was last updated on 7/19/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatricsMD00046873WASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11123256MEDICAIDWASHINGTON
2P46873MEDICARE UPINWASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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