Kathleen Russell, CSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

A5050 Issued in OR

Practice address

7700 SW Garden Home Rd Apt 23
Portland, OR 97223-7496

Phone

(503) 572-9340

NPI assigned

Oct 31, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604102400000",
    "number": "1063012649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4931 SW 76TH AVE # 128",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972251805",
            "telephone_number": "503-572-9340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 SW GARDEN HOME RD APT 23",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972237496",
            "telephone_number": "503-572-9340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "KATHLEEN",
        "credential": "CSWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-31",
        "last_updated": "2020-10-31",
        "certification_date": "2020-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "A5050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Douglas Russell, RN
• John Michael Russell, PMHNP
• Joseph Taylor Russell, PWS, CRM, CADC-R
• Julie Ann Russell, LMFT
• June Marilyn Russell, M.D.
• Kelly Russell, M.S.
• Kraig M Russell, MD
• Lauren B Russell, RN
• Marie-Louise Russell, M.A.
• Mary Ann Russell, LPC

• Clinical Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.