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Contact Information

BRIAN RUSSO, PA
751 NE BLAKEY DRIVE
SWEDISH MEDICAL CENTER
ISSAQUAH, WA98027
 Phone: 425-394-0610
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for BRIAN RUSSO · (Male)

NPI # 1427301084
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 10/19/2012
Last updated 11/06/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers
  • WA License # 60310413
Hospital affiliation(s)
  • PROVIDENCE REGIONAL MEDICAL CENTER EVERETT - (Acute Care)
    1321 COLBY AVENUE
    EVERETT, WA 98201
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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