Healthcare Provider Details

I. General information

NPI: 1982461935
Provider Name (Legal Business Name): ALAINA RUSSELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2024
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6444 FAIRWAY AVE SE STE 100
SALEM OR
97306-3073
US

IV. Provider business mailing address

8220 SE 6TH AVE APT 102
PORTLAND OR
97202-6598
US

V. Phone/Fax

Practice location:
  • Phone: 971-901-2731
  • Fax:
Mailing address:
  • Phone: 541-297-6404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: