Mary Ann Russell, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MC60301227 Issued in WA

Practice address

9316 SE Salmon CT
Portland, OR 97216-2110

Phone

(360) 633-0036

NPI assigned

Nov 1, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Native American Rehabilitation Assoc Inc

  dba Nara NW

  • Federally Qualified Health Center (FQHC)
  • Portland, OR
  • NPI 1396734364
  Medicare reassignment NPD
• Native American Rehabilitation Assoc Inc

  dba Nara NW-Gresham

  • Federally Qualified Health Center (FQHC)
  • Portland, OR
  • NPI 1942747761
  NPD

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

{
    "created_epoch": "1351728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1538413323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9316 SE SALMON CT",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162110",
            "telephone_number": "360-633-0036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9316 SE SALMON CT",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162110",
            "telephone_number": "360-633-0036"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "703 NE Hancock St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972123955",
            "country_code": "US",
            "telephone_number": "503-230-9875",
            "fax_number": "503-331-3441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "MARY",
        "middle_name": "ANN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-01",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C7466",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC60301227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Russell, CSWA
• Kelly Russell, M.S.
• Kraig M Russell, MD
• Lauren B Russell, RN
• Marie-Louise Russell, M.A.
• Mary Catherine Russell, FNP
• Melissa Russell
• Nicole S Russell, BSW
• Scarlett Russell, RN/QMHP-R
• Stephanie Russell, LMT

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.