Provider Demographics
NPI:1518254853
Name:CASH, RUSSELL DEE (BOARD CERTIFIED)
Entity Type:Individual
Prefix:MR
First Name:RUSSELL
Middle Name:DEE
Last Name:CASH
Suffix:
Gender:M
Credentials:BOARD CERTIFIED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6876 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-8501
Mailing Address - Country:US
Mailing Address - Phone:208-376-9431
Mailing Address - Fax:208-378-0747
Practice Address - Street 1:6876 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-8501
Practice Address - Country:US
Practice Address - Phone:208-376-9431
Practice Address - Fax:208-378-0747
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-07
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDHA-181237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist