Active NPI
Mara Russell, D.C.
- Chiropractor
- Issaquah, WA
National Provider Identifier
1548670631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH60455045
- Practice address
- 1151 NW Sammamish Rd
#101
Issaquah, WA 98027-8937 - Phone
- (425) 369-1040
- NPI assigned
- Apr 29, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH60455045 | WA | Primary |
Addresses
Primary practice location
1151 NW Sammamish Rd
#101
Issaquah, WA 98027-8937
Mailing address
1151 NW Sammamish Rd
#101
Issaquah, WA 98027-8937
Phone (425) 369-1040
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CH60455045 | WA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435622400000",
"number": "1548670631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1151 NW SAMMAMISH RD",
"address_2": "#101",
"city": "ISSAQUAH",
"state": "WA",
"postal_code": "980278937",
"telephone_number": "425-369-1040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1151 NW SAMMAMISH RD",
"address_2": "#101",
"city": "ISSAQUAH",
"state": "WA",
"postal_code": "980278937",
"telephone_number": "425-369-1040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "MARA",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-04-29",
"last_updated": "2015-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WA",
"license": "CH60455045",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Issaquah, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.