Individual
MRS. DEANNA NICOLE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
800 NE 2ND ST, MCMINNVILLE, OR 97128-4408
(503) 472-2240
(503) 434-5848
Mailing address
23842 SW PINECONE AVE, SHERWOOD, OR 97140-6264
(971) 732-5858
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
INTERN #RO600
OR
Other
Enumeration date
05/16/2007
Last updated
07/08/2007
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