Christopher Russo

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW61088963 Issued in WA

Practice address

1904 3Rd Ave
Seattle, WA 98101-1126

Phone

(206) 309-5990

NPI assigned

Oct 16, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 8, 2024 through Mar 8, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Seattle Anxiety, PLLC

  dba Seattle Anxiety Specialists, PLLC

  • Psychiatry Physician
  • Seattle, WA
  • NPI 1629512066

  Clinical

  NPD

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

{
    "created_epoch": "1539648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1427524636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1904 3RD AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 3RD AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011126",
            "telephone_number": "206-309-5990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "CHRISTOPHER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-16",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "LW61088963",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61088963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Russell, LPN
• Stacy Michaela Russell, MD
• Ellery T. Russian, DPT
• Alexandra Russo
• Alfred John Russo, D.A.O.M., L.AC.
• Monica Russo, LICSW, CDP
• Anne Marie Rust
• Nancy Myers Rust
• Monika J Rustad, OT
• James M Rustamier, PAC

• Clinical Social Worker in Seattle, WA
• Providers in Seattle, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.