Provider Demographics
NPI:1386969889
Name:RUSSELL, CHRISTINE ANDREA (AUD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:ANDREA
Last Name:RUSSELL
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:CHRISTINE
Other - Middle Name:ANDREA
Other - Last Name:TOBIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:3100 N COUNTY ROAD 25 E
Mailing Address - Street 2:
Mailing Address - City:BELLVUE
Mailing Address - State:CO
Mailing Address - Zip Code:80512-5922
Mailing Address - Country:US
Mailing Address - Phone:970-217-7087
Mailing Address - Fax:970-797-1248
Practice Address - Street 1:3100 N COUNTY ROAD 25 E
Practice Address - Street 2:
Practice Address - City:BELLVUE
Practice Address - State:CO
Practice Address - Zip Code:80512-5922
Practice Address - Country:US
Practice Address - Phone:970-217-7087
Practice Address - Fax:970-797-1248
Is Sole Proprietor?:No
Enumeration Date:2010-03-29
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO572231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist