Russell Owen Funk, M.S.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH00006320 Issued in WA

Practice address

135 W Main St
Chehalis, WA 98532-4817

Phone

(360) 748-6696

Fax

(360) 748-0627

NPI assigned

Jan 19, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467505636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 491",
            "city": "CASTLE ROCK",
            "state": "WA",
            "postal_code": "986110491",
            "telephone_number": "360-274-4003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 W MAIN ST",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985324817",
            "telephone_number": "360-748-6696",
            "fax_number": "360-748-0627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNK",
        "first_name": "RUSSELL",
        "middle_name": "OWEN",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00006320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Paul Frietze, LMT, NAC
• Stephanie L Fritz-Ta
• Helmuth Franz Fritz, MD, RVT
• Kenton Fritz, PA
• Brianna Leeann Fuentes
• Teresa Gaiser
• Jay Valentine Gallinger, O.D.
• David L Gano, MD
• Anita R Gantry Dotson, MS SLP A CCC
• Julie Garcia

• Mental Health Counselor in Chehalis, WA
• Providers in Chehalis, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.