Provider Demographics
NPI:1780429258
Name:RUSSELL, CHRISTI M (SMC FCDBC)
Entity type:Individual
Prefix:
First Name:CHRISTI
Middle Name:M
Last Name:RUSSELL
Suffix:
Gender:F
Credentials:SMC FCDBC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3655 W 13TH AVE # L246
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-3487
Mailing Address - Country:US
Mailing Address - Phone:815-209-7207
Mailing Address - Fax:
Practice Address - Street 1:3655 W 13TH AVE # L246
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-3487
Practice Address - Country:US
Practice Address - Phone:815-209-7207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula