Ethan Budd Russo, is a
Psychiatry & Neurology - Neurology physician based in Vashon, Washington. Ethan Budd Russo is licensed to practice in Washington (license number 00018304) and his current practice location is 20402 81st Avenue Sw, Vashon, Washington. He can be reached at his office (for appointments etc.) via phone at
(206) 304-4344.
NPI number for Ethan Budd Russo is 1760024632 and his current mailing address is 20402 81st Avenue Sw, Vashon, Washington. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1760024632.
Physician's Profile
| Full Name | Ethan Budd Russo |
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| Gender | Male |
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| Speciality | Psychiatry & Neurology - Neurology |
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| Location | 20402 81st Avenue Sw, Vashon, Washington |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1760024632
- Provider Enumeration Date: 10/12/2019
- Last Update Date: 10/12/2019
Medical Identifiers
Medical identifiers for Ethan Budd Russo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1760024632 | NPI | - | NPPES |
| 00018304 | Other | WA | WASHINGTON STATE MEDICAL LICENSE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 00018304 (Washington) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ethan Budd Russo is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ethan Budd Russo,
20402 81st Avenue Sw,
Vashon, WA 98070-6253
Ph: (206) 304-4344 | Ethan Budd Russo,
20402 81st Avenue Sw,
Vashon, WA 98070-6253
Ph: (206) 304-4344 |
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