Russ, R

Russ, R is an individual health care provider with primary practice located at 748 14Th Ave , Longview WA 98632-2315. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is his primary health care specialty. Russ, R can be contacted via phone (360) 200-5419.

Contact Information

Primary practice address
748 14Th Ave Longview WA 98632-2315
Phone: (360) 200-5419
Fax: (360) 200-6736
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X CP00000957 Washington
Behavioral Health & Social Service Providers / Psychologist 103T00000X PY60373444 Washington

Profile Details

NPI number 1023449634
LBN Legal business name Russ, R
Credentials PH.D., SUDP
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 6th, 2013
Last updated Nov 12th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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