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Russ Pulliam
Peer Specialist in Grants Pass, Oregon
NPI 1114447695

Russ Pulliam is a Peer Specialist based in Grants Pass, OR. Russ Pulliam practices in Grants Pass, OR. The NPI Number for Russ Pulliam is 1114447695 and holds a License No. (Oregon).

The current practice location address for Russ Pulliam is 1215 Sw G St, Grants Pass, OR and can be reached out via phone at 541-476-2373. You can also correspond with Russ Pulliam through the mailing address at 1215 SW G ST, GRANTS PASS, OR - 97526-2544 (mailing address contact number: 541-476-2373).

Location: 1215 Sw G St, Grants Pass, OR, 97526-2544
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1114447695
Provider Name
Russ Pulliam
Credential
Provider Entity Type
Individual
Gender
Male
Address
1215 Sw G St, Grants Pass, OR, 97526-2544
Phone Number
541-476-2373
Fax Number
Provider Enumeration Date
06/26/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1215 Sw G St
City
Grants Pass
State
Oregon
Zip
97526-2544
Phone Number
541-476-2373
Fax Number
person
Provider Business Mailing Address Details
Address
1215 Sw G St
City
Grants Pass
State
Oregon
Zip
97526-2544
Phone Number
541-476-2373
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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