Haley Russo

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

10714 NE Glisan St
Portland, OR 97220-4046

Phone

(503) 256-2453

NPI assigned

Mar 7, 2022

Sex

Female

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)

Not enrolled

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 and National Provider Directory roles.

• Lifeworks NW

  • Mental Health Counselor
  • Portland, OR
  • NPI 1467408013
  NPD

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

{
    "created_epoch": "1646611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1659028843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12628 SW 172ND TER APT 205",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970072087",
            "telephone_number": "714-353-7516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10714 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972204046",
            "telephone_number": "503-256-2453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "HALEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-07",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Russellville III LLC (Russellville Park)
• Kristin Russio
• Barry Sheldon Russman, MD
• Andrea Russo, CRM
• Diana Marie Russo
• Larry Russock
• Bethany Russotto, PA-C
• Chloe Rust
• Randee L Rust, LMT
• Marivic Rustia

• Case Manager/Care Coordinator in Portland, OR
• Providers in Portland, OR by specialty
• Case Manager/Care Coordinator in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; 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.