Individual
AUTUMN STARR RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC II, QMHA I
Contact information
Practice address
4211 W 11TH AVE, EUGENE, OR 97402-5435
(541) 687-1110
Mailing address
PO BOX 8549, COBURG, OR 97408-1313
(541) 617-4544
(541) 385-4755
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14-12-25
OR
Other
Enumeration date
02/09/2016
Last updated
04/21/2026
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