Tavisha Nakia Russell, CNA

Primary specialty

Nurse's AideTaxonomy code 376K00000X

License

NC60272176 Issued in WA

Practice address

9600 Veterans Drive
Lakewood, WA 98493

Phone

(253) 582-8440

NPI assigned

May 1, 2014

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1398902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398902400000",
    "number": "1114337003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9916 24TH AVENUE CT S",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984447743",
            "telephone_number": "253-217-1763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 VETERANS DRIVE",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "98493",
            "telephone_number": "253-582-8440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "TAVISHA",
        "middle_name": "NAKIA",
        "credential": "CNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-01",
        "last_updated": "2014-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "WA",
            "license": "NC60272176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NAC",
            "identifier": "NC60272176",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Haley Rusbuldt
• Amber Leanne Rush
• Diana Sue Rush, L.M.P.
• Michaela Russ
• Erin Lynn Russell, LMP
• Lynette Rutherford
• Mark D Rutherford, DC
• Mary Claire Rutherford, ARNP, MSN, MPH
• Alexandra Elizabeth Rutledge
• Melinda Ruziska, HS

• Nurse's Aide in Lakewood, WA
• Providers in Lakewood, WA by specialty
• Nurse's Aide in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.