Provider Demographics
NPI:1851428361
Name:RUSSELL, BARBARA ANN (ATC)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:ANN
Last Name:RUSSELL
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:M4F BOHLER ATHLETIC COMPLEX
Mailing Address - Street 2:WASHINGTON STATE UNIVERSITY
Mailing Address - City:PULLMAN
Mailing Address - State:WA
Mailing Address - Zip Code:99164-1602
Mailing Address - Country:US
Mailing Address - Phone:509-335-5747
Mailing Address - Fax:509-335-4729
Practice Address - Street 1:M4F BOHLER ATHLETIC COMPLEX
Practice Address - Street 2:WASHINGTON STATE UNIVERSITY
Practice Address - City:PULLMAN
Practice Address - State:WA
Practice Address - Zip Code:99164-1602
Practice Address - Country:US
Practice Address - Phone:509-335-5747
Practice Address - Fax:509-335-4729
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer