Individual
JOSEPH TAYLOR RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PWS, CRM, CADC-R
Contact information
Practice address
80 SE MADISON ST STE 210, PORTLAND, OR 97214-4527
(971) 373-8170
Mailing address
80 SE MADISON ST STE 210, PORTLAND, OR 97214-4527
(971) 373-8170
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699550434
—
OR
Enumeration date
06/20/2025
Last updated
06/20/2025
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