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Search › Washington › 152W00000X

Russell Lake, O.D

NPI 1720603392 · on the registry since 2020

Practice

Address
375 Highline Dr
East Wenatchee, WA 98802
Phone
(509) 886-0924
Organisation at this address
Costco Wholesale Corporation
Costco Wholesale Corporation
Inferred from a shared address, not stated in the registry.
Clinicians at this address
6

Registry record

Primary taxonomy
152W00000X
152W00000X
Licence states on file
WA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2020-06-10

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Washington