Organization
JULIE RUSSELL FAMILY COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JULIE ANN RUSSELL MA, R2546, R2647 (CLINCIAL MANAGER)
(503) 312-9163
Entity
Organization
Contact information
Practice address
11740 SW WARNER AVE, TIGARD, OR 97223-8459
(503) 312-9163
(503) 430-7207
Mailing address
11740 SW WARNER AVE, TIGARD, OR 97223-8459
(503) 312-9163
(503) 430-7207
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
R2646, R2647
OR
Other
Enumeration date
06/28/2012
Last updated
10/21/2013
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