Russell W Faria DO PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

D020354 Issued in OR

Legal business name

RUSSELL W FARIA DO PC

Practice address

15215 SE 272ND St Ste 103
Kent, WA 98042-4215

Phone

(253) 639-1883

Fax

(253) 639-1891

NPI assigned

Mar 4, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Trish Bukauskas

Title

Billing MGR

Phone

(843) 293-9966

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204588800000",
    "number": "1457521619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15215 SE 272ND ST STE 103",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980424215",
            "telephone_number": "253-639-1883",
            "fax_number": "253-639-1891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15215 SE 272ND ST STE 103",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980424215",
            "telephone_number": "253-639-1883",
            "fax_number": "253-639-1891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL W FARIA DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-04",
        "last_updated": "2008-03-04",
        "status": "A",
        "authorized_official_last_name": "BUKAUSKAS",
        "authorized_official_first_name": "TRISH",
        "authorized_official_title_or_position": "BILLING MGR",
        "authorized_official_telephone_number": "843-293-9966",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "D020354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150278",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "D020354",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ada Abdy Rubalcaba
• Jessica Rubinstein, LMFTA
• Magdalena Sophia Ruiz
• Teri K. Rupp, OT
• Tina Lavina Russeff, LMT
• Claire Russell, D.C.
• James M Russo, MD
• Morgan Rutkowski
• Elizabeth Anne Rutledge, COTA
• Marcola Rayona Ryan

• Family Medicine Physician in Kent, WA
• Providers in Kent, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; 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.