Jenna Russell, PT, DPT, CLT
Individual provider Active NPI Physical Therapist · Inchelium, WA
NPI 1750108510 · NPPES record last updated Mar 17, 2026
Key facts
- NPI
- 1750108510
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT61562602 (WA)
- Practice address
- 39 Shortcut Rd
Inchelium, WA 99138 - Phone
- (509) 722-7064
- NPI assigned
- Sep 23, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Colville Nation Community Health Centers
Practice addresses (Care Compare)
39 Short Cut Rd
PO Box 290
Inchelium, WA 99138-0290
PO Box
Suite 290
Inchelium, WA 99138-0290
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250818000080 | TX | Practitioner - Physical Therapist in Private Practice | 1557860533 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT61562602 | WA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Colville Nation Community Health Centers | Current | Accepting new patients | |
| Colville Nation Community Health Centers | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT61562602 | WA | Yes |
Addresses
Primary practice location
39 Shortcut Rd
Inchelium, WA 99138
Mailing address
PO Box 242
Inchelium, WA 99138-0242
Phone (509) 808-9074
Other providers in Inchelium, WA
- Juliann Munkers
- Bessie Jean Nugent
- Kaley Jo Obrien
- Mia Lynn Pakootas
- Kim Rosenthal
- Jeremiah Johnson Salmond
- Emily Lorraine Sardual
- Jazminn Simpson
- Kimberly Rose Simpson
- Susan Dawn Solomon-Hopkins
All providers in Inchelium, WA · Physical Therapist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.