Individual
MRS. NICOLE S RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
3550 SE WOODWARD ST, PORTLAND, OR 97202-1552
(503) 813-7757
Mailing address
2307 NW SCHMIDT WAY, APT. 12, BEAVERTON, OR 97006-4793
(503) 998-2715
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
06/04/2007
Last updated
07/08/2007
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