Individual
DEBORAH LEIGH RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LMHC, MHP
Contact information
Practice address
3857 MARTIN WAY E, OLYMPIA, WA 98506
(360) 704-7170
(360) 438-2926
Mailing address
3857 MARTIN WAY E, OLYMPIA, WA 98506-5268
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
60146258
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100672
—
WA
Enumeration date
06/21/2017
Last updated
06/21/2017
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