Individual
DAWN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1215 SW G ST, GRANTS PASS, OR 97526-2544
(541) 476-2373
Mailing address
1215 SW G ST, GRANTS PASS, OR 97526-2544
(541) 476-2373
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
163W00000X
Registered Nurse
Primary
201604414RN
OR
Other
Enumeration date
02/01/2017
Last updated
02/01/2017
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