Individual
RUSS WOLFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRM
Contact information
Practice address
10700 SW BEAVERTON HILLSDALE HWY BLDG 1, BEAVERTON, OR 97005-3019
(503) 641-1475
Mailing address
5415 SW WESTGATE DR, PORTLAND, OR 97221-2409
(503) 645-3581
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
25-CRM-4470
OR
Other
Enumeration date
06/09/2025
Last updated
06/09/2025
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