ETHAN BUDD RUSSO (NPI# 1760024632) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760024632 |
| Entity Type | Individual |
| Full Name | ETHAN BUDD RUSSO |
| Practice Address |
20402 81st Avenue Sw Vashon WA 98070-6253 |
| Practice Telephone | 2063044344 |
| Mailing Telephone | 2063044344 |
| Enumeration Date | 2019-10-12 |
| Last Update Date | 2019-10-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
00018304 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | WASHINGTON STATE MEDICAL LICENSE | 00018304 | 01 |
| Street Address |
20402 81ST AVENUE SW |
| City | VASHON |
| State | WA |
| Zip Code | 98070-6253 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932683364 | Helen B Taylor | Counselor | 17223 Vashon Hwy Sw, Vashon, WA 98070 | 2018-09-21 |
| 1356857064 | Meagan Fitzgerald | Counselor | Vashon Youth and Family Services, 20110 Vashon Hwy Sw, Vashon, WA 98070 | 2017-12-18 |
| 1336669621 | Susan Beth James | Social Worker | 17635 100th Ave. Sw, Vashon, WA 98070 | 2017-06-27 |
| 1134659915 | Dianna Jean Ammon | Massage Therapist | 17731 Vashon Highway Sw, Vashon Intuitive Arts, Vashon, WA 98070 | 2017-06-14 |
| 1750836003 | Kim L. Newall | Counselor | 20110 Vashon Hywy Sw, Vashon Island, WA 98070 | 2016-08-16 |
| 1982941217 | Amber D Matusky | Doula | 25202 120th Ave Sw, Vashon, WA 98070 | 2013-01-07 |
| 1003179862 | Lisa Sigrid Coley | Counselor | 20110 Vashon Highway Sw, Vashon, WA 98070 | 2012-06-18 |
| 1154683233 | Holly Marie Roland | Counselor | 9329 Sw Cemetery Rd, Vashon, WA 98070 | 2012-06-13 |
| 1467727859 | Vashon Family Dentistry | Dentist | 19001 Vashon Hwy Sw Ste 100, Vashon, WA 98070 | 2012-03-19 |
| 1033348800 | Elizabeth Torbert White | Social Worker | 19001 Vashon Highway Sw, Vashon, WA 98070 | 2009-07-14 |
| Find all providers in zip 98070 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720608235 | Alexander John Arnold | Psychiatry & Neurology | 1959 Ne Pacific St, Rr650, Seattle, WA 98195 | 2020-04-24 |
| 1730683053 | Selkirk Neurology Pllc | Psychiatry & Neurology | 610 S Sherman St Ste 201, Spokane, WA 99202-1342 | 2018-03-21 |
| 1881116341 | William Russell Schmidt | Psychiatry & Neurology | 12207 243rd Pl Ne, Redmond, WA 98053-5685 | 2017-07-16 |
| 1568872281 | Marie-sarah Gagne Brosseau | Psychiatry & Neurology | 1536 N 115th Street, Suite 130, Seattle, WA 98133 | 2014-05-02 |
| 1972920049 | Anusha Mannava | Psychiatry & Neurology | 1100 Goethals Dr Ste D, Richland, WA 99352 | 2014-03-26 |
| 1275954646 | George Delyanis | Psychiatry & Neurology | 1220 Ventura Dr, Tacoma, WA 98465-1240 | 2014-01-02 |
| 1326381500 | Jill Kaspar Baird | Psychiatry & Neurology | 2121 Ne 139th St Ste 205, Vancouver, WA 98686-2316 | 2013-04-05 |
| 1124361993 | Malveeka Sharma | Psychiatry & Neurology | 325 9th Ave Rm 3ct70, Seattle, WA 98104 | 2013-03-31 |
| 1124367776 | Tilahun Haile Abraha | Psychiatry & Neurology | 317 Nine Bark St Nw, Olympia, WA 98502-8709 | 2013-02-01 |
| 1962740274 | Legacy Neuromonitoring, LLC | Psychiatry & Neurology | 1818 W Francis Ave, Pmb #299, Spokane, WA 99205-6834 | 2013-01-21 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.