Provider Demographics
NPI:1215140322
Name:ROSSELL, ASHLEY I (LAC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:I
Last Name:ROSSELL
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:ASHLEY
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:619 MEADOWS DR E
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-9797
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:303 CASEY AVE STE C
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-4368
Practice Address - Country:US
Practice Address - Phone:509-378-5817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00002445171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist