Individual provider Active NPI

Mai T Russell, MD

  • Neuroradiology Physician
  • Seattle, WA
National Provider Identifier
1962511709
Registry record updated Jul 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
MD00045065 Issued in WA
Practice address
1200 12TH Ave S
Seattle, WA 98144-2712
Phone
(509) 747-4455
Fax
(509) 363-7064
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X MD00045065 WA Primary

Addresses

Primary practice location

1200 12TH Ave S
Seattle, WA 98144-2712

Mailing address

801 S Stevens St
Spokane, WA 99204-2654
Phone (509) 363-7313

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, MT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070430000328 WA Practitioner - Diagnostic Radiology 5193821692 Reassigns benefits to 10 organizations
I20160519001410 MT Practitioner - Diagnostic Radiology 5193821692 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Saint Louis University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inland Imaging LLCGroup PAC ID 6608763016, 128 clinicians
The Polyclinic PLLCGroup PAC ID 2163328196, 364 clinicians
Inland Imaging Associates PSGroup PAC ID 7810327210, 124 clinicians
Integra Imaging PSGroup PAC ID 1355593062, 126 clinicians

Practice addresses (Care Compare)

105 W 8TH Ave
Suite 100C and 125C
Spokane, WA 99204-2302
Phone (509) 747-4455

1145 Broadway
Seattle, WA 98122-4201
Phone (206) 329-1760

1200 12TH Ave S
Seattle, WA 98144-2712
Phone (509) 363-7788

12420 E Mission Ave
Spokane Valley, WA 99216-1051
Phone (509) 747-4455

16528 E Desmet CT
Suite A1300
Spokane Valley, WA 99216-3522
Phone (509) 747-4455

1936 Sunset Ave SW
Seattle, WA 98116-1950
Phone (509) 363-7745

2360 Mullan Rd
Suite C
Missoula, MT 59808-1811
Phone (509) 363-7788

2419 Mullan Rd
Suite D
Missoula, MT 59808-1856
Phone (509) 363-7788

401 W Poplar St
Walla Walla, WA 99362-2846
Phone (509) 363-7745

500 E Webster Ave
Chewelah, WA 99109-9523
Phone (509) 363-7745

525 S Cowley St
Spokane, WA 99202-1381
Phone (509) 747-4455

551 E Hawthorne Rd
Spokane, WA 99218-1417
Phone (509) 747-4455

5715 N Lidgerwood St
Spokane, WA 99208-1225
Phone (509) 747-4455

7221 W Deschutes Ave
Kennewick, WA 99336-7807
Phone (509) 747-4455

747 Broadway
Seattle, WA 98122-4379
Phone (509) 363-7745

801 S Stevens St
Spokane, WA 99204-2654
Phone (509) 363-7745

904 7TH Ave
Seattle, WA 98104-1132
Phone (206) 309-1760

9631 N Nevada St
Suite 101
Spokane, WA 99218-1193
Phone (509) 747-4455

982 E Columbia Ave
Colville, WA 99114-3316
Phone (509) 363-7745

Hospital & facility affiliations

  • Kadlec Regional Medical Center Hospital, Richland, WA, CCN 500058
  • Providence St Mary Medical Center Hospital, Walla Walla, WA, CCN 500002
  • St. Patrick Hospital Hospital, Missoula, MT, CCN 270014
  • Prov Sacred HRT Med Ctr & Childs Hosp. Hospital, Spokane, WA, CCN 500054
  • Summit Pacific Medical Center Hospital, Elma, WA, CCN 501304

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00045065WAMDNeuroradiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Polyclinic PLLC Family Medicine Current Accepting new patients
Integra Imaging, PS CurrentSince Jan 1, 2013 Accepting new patients
Okanogan Douglas County Hospital Dist 1 Current Accepting new patients
Okanogan Douglas County Hospital Dist 1 Current Accepting new patients
Okanogan Douglas County Hospital Dist1 CurrentSince Apr 25, 2022 Accepting new patients
Okanogan Douglas County Hospital Dist 1 CurrentSince Apr 25, 2022 Accepting new patients
Columbia County Hospital District CurrentSince Jun 30, 2021 Accepting new patients
The Polyclinic CurrentSince May 1, 2007 Accepting new patients
Inland Imaging LLC CurrentSince May 1, 2007 Accepting new patients
Columbia County Hospital District CurrentSince Jan 1, 2026 Accepting new patients
Grant County Public Hospital District 3 CurrentSince Dec 16, 2025 Accepting new patients
Grant County Public Hospital District 2 CurrentSince Jan 4, 2023 Accepting new patients
Columbia County Hospital District CurrentSince Jun 30, 2021 Accepting new patients
The Polyclinic PLLC Family Medicine CurrentSince May 1, 2007 Accepting new patients
Integra Imaging, PS CurrentSince Jan 1, 2013 Accepting new patients
Inland Imaging Associates PS CurrentSince May 1, 2020 Accepting new patients
Inland Imaging Associates PS Neuroradiology Past Accepting new patients
Inland Pacific Imaging LLC Past Accepting new patients
Moses Lake Community Health Center Past Accepting new patients
Samaritan Inland MRI LLC Past Accepting new patients
Inland Imaging Arizona LLC Neuroradiology Past Accepting new patients

Locations

2360 Mullan Rd
Ste C
Missoula, MT 59808
Phone (406) 542-9695

2740 South Ave W
Missoula, MT 59804
Phone (406) 728-6010

2419 Mullan Rd
Ste D
Missoula, MT 59808
Phone (406) 540-1512

500 E Webster Ave
Chewelah, WA 99109
Phone (509) 482-2154

1012 S 3rd St
Dayton, WA 99328
Phone (509) 382-2531

200 Nat Washington Way
Ephrata, WA 98823
Phone (509) 754-3330

411 Fortuyn Rd
Grand Coulee, WA 99133
Phone (509) 633-1753

605 S Coolidge St
#101
Moses Lake, WA 98837
Phone (509) 765-0674

714 W Pine St
Newport, WA 99156
Phone (509) 447-2441

908 10th Ave SW
Quincy, WA 98848
Phone (509) 787-3503

1200 12th Ave S
Seattle, WA 98144
Phone (206) 326-2400

1101 Madison St
Ste 301
Seattle, WA 98104
Phone (206) 505-1101

1145 Broadway
Seattle, WA 98122

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

525 S Cowley St
Spokane, WA 99202
Phone (509) 625-3397

551 E Hawthorne Rd
Spokane, WA 99218
Phone (509) 252-1900

801 S Stevens St
Spokane, WA 99204
Phone (206) 621-4316

401 W Poplar St
Walla Walla, WA 99362
Phone (509) 522-5731

Organizations & group practices 21

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.

View all 21

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247616000000",
    "number": "1962511709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S STEVENS ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042654",
            "telephone_number": "509-363-7313",
            "fax_number": "509-363-7064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 12TH AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981442712",
            "telephone_number": "509-747-4455",
            "fax_number": "509-363-7064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "MAI",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2009-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "WA",
            "license": "MD00045065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.