JUSTIN JAKE RUSSELL L.M.P. NPI 1003092594

NPI Information

  • NPI: 1003092594
  • Provider Name: JUSTIN JAKE RUSSELL, L.M.P.
  • Classification: Specialist - 174400000X
  • Entity Type: Individual
  • Address: 22470 HUMPHREY DR
    LEAVENWORTH, WA
    ZIP 98826
  • Phone: (253) 389-7510

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NPI Details

Justin Jake Russell, L.M.P. is a specialist in Leavenworth, WA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. Justin Jake Russell, L.M.P. NPI is 1003092594. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

22470 HUMPHREY DR
LEAVENWORTH, WA
ZIP 98826-240
Phone: (253) 389-7510

The enumeration date for this NPI number is 1/14/2008 and was last updated on 8/14/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistMA00024875WASHINGTONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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