Organization
JULIE RUSSELL FAMILY COUNSELING, LLC
Active
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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