Individual
LUCIE M RUSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
9155 SW BARNES RD STE 634, PORTLAND, OR 97225-6632
(503) 216-6662
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
SC60768028
WA
1041C0700X
Clinical Social Worker
Primary
L13170
OR
Other
Enumeration date
05/02/2019
Last updated
04/25/2023
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