Active NPI
Carissa L Russell, RDH
- Dental Hygienist
- Othello, WA
National Provider Identifier
1750507166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- DH00006949
- Practice address
- 140 E Main Street
Othello, WA 99344 - Phone
- (509) 488-5256
- Fax
- (509) 488-9939
- NPI assigned
- Apr 17, 2007
- 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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | DH00006949 | WA | Primary |
Addresses
Primary practice location
140 E Main Street
Othello, WA 99344
Mailing address
140 E Main Street
Othello, WA 99344
Phone (509) 488-5256
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DH00006949 | WA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750507166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "140 E MAIN STREET",
"city": "OTHELLO",
"state": "WA",
"postal_code": "99344",
"telephone_number": "509-488-5256",
"fax_number": "509-488-9939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 E MAIN STREET",
"city": "OTHELLO",
"state": "WA",
"postal_code": "99344",
"telephone_number": "509-488-5256",
"fax_number": "509-488-9939"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "CARISSA",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "WA",
"license": "DH00006949",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Othello, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.