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Ethan Budd Russo
Neurology Physician in Vashon, Washington
NPI 1760024632

Ethan Budd Russo is a Neurology Physician based in Vashon, WA and is specialized in Neurology. Ethan Budd Russo practices in Vashon, WA. The NPI Number for Ethan Budd Russo is 1760024632 and holds a License No. 00018304 (Washington).

The current practice location address for Ethan Budd Russo is 20402 81St Avenue Sw, Vashon, WA and can be reached out via phone at 206-304-4344.

Location: 20402 81St Avenue Sw, Vashon, WA, 98070-6253
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1760024632
Provider Name
Ethan Budd Russo
Credential
Provider Entity Type
Individual
Gender
Male
Address
20402 81St Avenue Sw, Vashon, WA, 98070-6253
Phone Number
206-304-4344
Fax Number
Provider Enumeration Date
10/12/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00018304 01 WA WASHINGTON STATE MEDICAL LICENSE
institution
Provider Business Practice Location Address Details
Address
20402 81St Avenue Sw
City
Vashon
State
Washington
Zip
98070-6253
Phone Number
206-304-4344
Fax Number
person
Provider Business Mailing Address Details
Address
20402 81St Avenue Sw
City
Vashon
State
Washington
Zip
98070-6253
Phone Number
206-304-4344
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Psychiatry & Neurology
Speciality
Neurology
Taxonomy
2084N0400X
License No.
00018304 (Washington)
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
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