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1528427937
GRANT RUSS
MILWAUKIE, OR
NPI
1528427937
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2016-02-12
Last Update Date
2020-03-23
Business Address
GRANT RUSS
13850 SE AUTUMN RIDGE TER
MILWAUKIE, OR 97267-2150
Phone number: 503-974-9250
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Mailing Address
GRANT RUSS
3587 HEATHROW WAY
MEDFORD, OR 97504-4004
Phone number: 541-858-8170
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