MEDICARE: ORCAS ISLAND FAMILY MEDICINE, PC

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
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1194778498
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORCAS ISLAND FAMILY MEDICINE, PC

Provider Business Mailing Address
First Line	:	PO BOX 1989
Second Line	:
City	:	EASTSOUND
State	:	WA
Zip	:	98245-1989
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	429 MADRONA ST
Second Line	:
City	:	EASTSOUND
State	:	WA
Zip	:	98245-8573
Country	:	US
Telephone Number	:	360-376-4949
Fax Number	:	833-992-2162

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DAVID LEE RUSSELL
Credential	:	MD
Telephone Number	:	360-376-4949

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	07/22/2025

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