Healthcare Provider Details

I. General information

NPI: 1437060506
Provider Name (Legal Business Name): MEGAN KAY RUSSELL CPM, LM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N RIVERSIDE DR
WEST RICHLAND WA
99353-5213
US

IV. Provider business mailing address

601 N RIVERSIDE DR
WEST RICHLAND WA
99353-5213
US

V. Phone/Fax

Practice location:
  • Phone: 509-947-1567
  • Fax:
Mailing address:
  • Phone: 509-947-1567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: