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General NPI Number Information
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NPI Number | 1336053735
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Entity Type | Individual
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Provider Name | ELIZABETH MAY RUSSELL SLPA
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Gender | Female
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Dates
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Enumeration Date | 10/01/2026
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Last Update Date | 10/01/2026
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Provider Practice Location Address
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Address Line | 702 N GRANITE AVE
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City | GRANITE FALLS
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State | WA
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Zip | 98252-8774
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Country | US
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Telephone | 360-691-7719
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Fax |
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Provider Business Mailing Address
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Address Line | 20227 77TH AVE NE UNIT J103
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City | ARLINGTON
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State | WA
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Zip | 98223-4977
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Country | US
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Telephone | 509-393-2668
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | SLPA.SP.61689500
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License Number State | WA
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