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NPI Code Detail

MEDICARE: DR. JENNIFER RAGAN RUSSELL D.O.

MEDICARE: DR. JENNIFER RAGAN RUSSELL D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramDO210012353DC
2207ZP0007XMolecular Genetic Pathology (Pathology) PhysicianDO210012353DC
3207SM0001XMolecular Genetic Pathology (Medical Genetics) PhysicianDO210012353DC
4207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianDO210012353DC

General Provider Information

NPI Number : 1861465361
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER RAGAN RUSSELL D.O.
Provider Business Mailing Address
First Line : 7125 13TH PL NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20012
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 111 MICHIGAN AVE NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20010-2916
Country : US
Telephone Number : 917-855-9957
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2006
Last Update Date : 01/14/2026

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