Telly R Russell (NPI# 1780978338, PAC ID# 2163648635) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1780978338 |
| PAC ID by PECOS | 2163648635 |
| Professional Enrollment ID | I20140719000121 |
| Full Name | Telly R Russell |
| Organization Legal Name | VALLEY MEDICAL GROUP-RENTON |
| Address |
26458 Maple Valley Black Diamond Rd Se Maple Valley WA 98038-8350 |
| Phone Number | 4256565577 |
| Gender | M |
| Medical School | GEORGETOWN UNIVERSITY OF MEDICINE |
| Graduation Year | 2011 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 4183753965 |
| Number of Group Practice Members | 372 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 500088 | VALLEY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 26458 Maple Valley Black Diamond Rd Se, Maple Valley, WA 98038-8350 | 4256565577 | VALLEY MEDICAL GROUP-RENTON |
| Organization Legal Name | VALLEY MEDICAL GROUP-RENTON |
| Physicians | 382 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Padhma M Venkitapathy | Podiatry | Valley Medical Group-renton | 10555 Se Carr Rd, Bldg M, Renton, WA 98055-5820 |
| Zainab A Gaal-weber | Nurse Practitioner | Valley Medical Group-renton | 4033 Talbot Rd S, Suite 530, Renton, WA 98055-5700 |
| Olga Valieva Bishop | Obstetrics/gynecology | Valley Medical Group-renton | 1 E Main St, Suite 100, Auburn, WA 98002-4905 |
| Liane M Fernyhough | Nurse Practitioner | Valley Medical Group-renton | 24920 104th Ave Se, Kent, WA 98030-6443 |
| Kristen Drury | Physician Assistant | Valley Medical Group-renton | 26458 Maple Valley Black Diamond Rd Se, Maple Valley, WA 98038-8350 |
| Frederick D Park | Gastroenterology | Valley Medical Group-renton | 4011 Talbot Rd S, Suite 500, Renton, WA 98055-5782 |
| Aaron T Fang | Internal Medicine | Valley Medical Group-renton | 16850 Se 272nd St, Covington, WA 98042-4931 |
| Joshua H Kachner | Internal Medicine | Valley Medical Group-renton | 27203 216th Ave Se, Suite D, Maple Valley, WA 98038-3274 |
| Hsiang-hwa Chen | Family Medicine | Valley Medical Group-renton | 14410 Se Petrovitsky Rd, Suite 104, Renton, WA 98058-8900 |
| Emily K A Turnbull | Nurse Practitioner | Valley Medical Group-renton | 521 2nd Pl N, 11 103, Kent, WA 98032-4537 |
| Street Address |
26458 MAPLE VALLEY BLACK DIAMOND RD SE |
| City | MAPLE VALLEY |
| State | WA |
| Zip | 98038-8350 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kristen Drury | Physician Assistant | Valley Medical Group-renton | 26458 Maple Valley Black Diamond Rd Se, Maple Valley, WA 98038-8350 |
| Aaron K Von Krueger | Physician Assistant | Valley Medical Group-renton | 26458 Maple Valley Black Diamond Rd Se, Maple Valley, WA 98038-8350 |
| Laura Lynn Aguilar | Family Medicine | Valley Medical Group-renton | 26458 Maple Valley Black Diamond Rd Se, Maple Valley, WA 98038-8350 |
| Rodney T Riedel | Family Medicine | Valley Medical Group-renton | 26458 Maple Valley Black Diamond Rd Se, Maple Valley, WA 98038-8350 |
| Nissa Loving Kisler | Nurse Practitioner | Valley Medical Group-renton | 26458 Maple Valley Black Diamond Rd Se, Maple Valley, WA 98038-8350 |
| Lawrence John Madewell | Family Medicine | Valley Medical Group-renton | 26458 Maple Valley Black Diamond Rd Se, Maple Valley, WA 98038-8350 |
| Jennifer A Castelluccio | Physician Assistant | Valley Medical Group-renton | 26458 Maple Valley Black Diamond Rd Se, Maple Valley, WA 98038-8350 |
| Shawn Akavan | Family Medicine | Valley Medical Group-renton | 26458 Maple Valley Black Diamond Rd Se, Maple Valley, WA 98038-8350 |
| Laura E Eickelmann | Physician Assistant | Valley Medical Group-renton | 26458 Maple Valley Black Diamond Rd Se, Maple Valley, WA 98038-8350 |
| Christina G Kipelidis | Nurse Practitioner | Valley Medical Group-renton | 26458 Maple Valley Black Diamond Rd Se, Maple Valley, WA 98038-8350 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Phillip J Kriss | Chiropractic | 27203 216th Ave Se, Suite 1, Maple Valley, WA 98038-3273 | |
| Joshua H Kachner | Internal Medicine | Valley Medical Group-renton | 27203 216th Ave Se, Suite D, Maple Valley, WA 98038-3274 |
| Jeffrey J Ramos | Physical Therapy | 27203 216th Ave Se, Suite 10, Maple Valley, WA 98038-3274 | |
| Shannon L Markegard | Family Medicine | Valley Medical Group-renton | 27203 216th Ave Se, Suite D, Maple Valley, WA 98038-3274 |
| Travis A Dalton | Nurse Practitioner | Valley Medical Group-renton | 27203 216th Ave Se, Suite D, Maple Valley, WA 98038-3274 |
| Jessica A Mcabee | Family Medicine | Valley Medical Group-renton | 27203 216th Ave Se, Suite D, Maple Valley, WA 98038-3274 |
| Shreeketa M Mehta | Family Medicine | Valley Medical Group-renton | 27203 216th Ave Se, Suite D, Maple Valley, WA 98038-3274 |
| David W Sweiger | Family Medicine | Valley Medical Group-renton | 27203 216th Ave Se, Suite D, Maple Valley, WA 98038-3274 |
| Kathryn Laurel Anderson | Nurse Practitioner | Traveling Pain Management Doctors Psc | 23745 225th Way Se, Suite 201b, Maple Valley, WA 98038-3350 |
| Amanda Sahar Jenkins | Nurse Practitioner | Traveling Pain Management Doctors Psc | 23745 225th Way Se, Suite 201b, Maple Valley, WA 98038-3350 |
| Find all physicians in zip 98038 | |||
| City | MAPLE VALLEY |
| Zip Code | 98038 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | MAPLE VALLEY + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Telly R Russell.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.