ETHAN BUDD RUSSO NPI 1760024632

NPI Information

NPI: 1760024632
Provider Name: ETHAN BUDD RUSSO
Classification: Psychiatry & Neurology - 2084N0400X
Specialization: Neurology
Entity Type: Individual
Address: 20402 81ST AVENUE SW
VASHON, WA
ZIP 98070
Phone: (206) 304-4344

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NPI Details

Ethan Budd Russo is a neurology psychiatry neurology in Vashon, WA. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. Ethan Budd Russo NPI is 1760024632. 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:

20402 81ST AVENUE SW
VASHON, WA
ZIP 98070-253
Phone: (206) 304-4344

The enumeration date for this NPI number is 10/12/2019 and was last updated on 10/12/2019.

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
1	2084N0400X	Psychiatry & Neurology	Neurology	00018304	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00018304	OTHER	WASHINGTON	WASHINGTON STATE MEDICAL LICENSE

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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