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Tana Russell, CDP
Addiction (Substance Use Disorder) Counselor in Lacey, Washington
NPI 1487151577

Tana Russell is an Addiction (Substance Use Disorder) Counselor based in Lacey, WA and is specialized in Addiction (Substance Use Disorder). Tana Russell practices in Lacey, WA and has the professional credentials of CDP. The NPI Number for Tana Russell is 1487151577 and holds a License No. CP60520052 (Washington).

The current practice location address for Tana Russell is 4800 College St Se, Lacey, WA and can be reached out via phone at 253-651-1054 and via fax at 360-493-5088.

Location: 4800 College St Se, Lacey, WA, 98503-4389
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Provider Profile Details
NPI Number
1487151577
Provider Name
Tana Russell
Credential
CDP
Provider Entity Type
Individual
Gender
Female
Address
4800 College St Se, Lacey, WA, 98503-4389
Phone Number
253-651-1054
Fax Number
360-493-5088
Provider Enumeration Date
04/06/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
CP60520052 05 WA
institution
Provider Business Practice Location Address Details
Address
4800 College St Se
City
State
Zip
98503-4389
Phone Number
253-651-1054
Fax Number
360-493-5088
person
Provider Business Mailing Address Details
Address
4800 College St Se
City
State
Zip
98503-4389
Phone Number
253-651-1054
Fax Number
360-493-5088
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
CP60520052 (Washington)
Definition
Definition to come...
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