Provider Demographics
NPI:1003971870
Name:RUSSELL & HANSEN PLLC
Entity Type:Organization
Organization Name:RUSSELL & HANSEN PLLC
Other - Org Name:ERIC W RANTA & DAVID S RUSSELL INC PS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:C
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-524-6116
Mailing Address - Street 1:3819 NE 45TH STREET
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-5144
Mailing Address - Country:US
Mailing Address - Phone:206-524-6116
Mailing Address - Fax:206-528-0406
Practice Address - Street 1:3819 NE 45TH STREET
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-5144
Practice Address - Country:US
Practice Address - Phone:206-524-6116
Practice Address - Fax:206-528-0406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty