Individual
MR. MICHAEL LAWRENCE CADY RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, NCC, LPC
Contact information
Practice address
1942 NW KEARNEY ST, SUITE 32, PORTLAND, OR 97209-1426
(503) 683-2341
Mailing address
2822 SE SALMON ST, PORTLAND, OR 97214-4136
(503) 679-3798
(503) 914-1791
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C4675
OR
101YP2500X
Professional Counselor
R2739
OR
101YS0200X
School Counselor
143715
OR
Other
Enumeration date
10/31/2014
Last updated
03/16/2022
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