Provider Demographics
NPI:1558487983
Name:RUSSELL, MARGARET MARY (MD)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:MARY
Last Name:RUSSELL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:501 S 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-3550
Mailing Address - Country:US
Mailing Address - Phone:509-494-6700
Mailing Address - Fax:509-573-6275
Practice Address - Street 1:1806 W LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902
Practice Address - Country:US
Practice Address - Phone:094-524-5205
Practice Address - Fax:509-452-5224
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMD 60037574207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WABR9328382OtherDEA