| Doctor Name: | TAMARA LYNNE RUSSELL |
| NPI Number: | 1699722975 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSYD |
| License Number: | PY00003727 |
| Business Practice Address: | 317 E Johnson Ave Chelan, WA - 988162920 |
| Business Phone Number: | 5096826000 |
| Business Fax Number: | 5096826296 |
| Mailing Address: | 600 Orondo Ave, Suite 1 WENATCHEE |
| State: | WA |
| Postal Code: | 988012800 |
| Phone Number: | 5096626000 |
| Fax Number: | |
| NPI Enumeration Date: | 05/30/2006 |
| NPI Last Update Date: | 01/13/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PY00003727 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |