Individual
DR. R RUSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D., SUDP
Contact information
Practice address
1548 RIVER RD UNIT 105, LONGVIEW, WA 98632-3293
(520) 260-4584
Mailing address
PO BOX 2394, LONGVIEW, WA 98632-8455
(360) 200-5419
(360) 200-6736
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CP00000957
WA
103T00000X
Psychologist
Primary
PY60373444
WA
Other
Enumeration date
12/06/2013
Last updated
05/12/2025
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