Russell Owen Funk, MS | |
135 W Main St, Chehalis, WA 98532-4817 | |
(360) 748-6696 | |
(360) 748-0627 |
Full Name | Russell Owen Funk |
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Gender | Male |
Speciality | Counselor - Mental Health |
Location | 135 W Main St, Chehalis, Washington |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1467505636 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | LH00006320 (Washington) | Primary |
Entity Name | Lewis County Mental Health Association |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1619068624 PECOS PAC ID: 5496641177 Enrollment ID: O20040227000824 |
Mailing Address | Practice Location Address |
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Russell Owen Funk, MS Po Box 491, Castle Rock, WA 98611-0491 Ph: (360) 274-4003 | Russell Owen Funk, MS 135 W Main St, Chehalis, WA 98532-4817 Ph: (360) 748-6696 |
Catherine Fetters, MA, MHP Counselor Medicare: Not Enrolled in Medicare Practice Location: 151 N Market Blvd, Chehalis, WA 98532 Phone: 360-948-0203 | |
Tomas D Mino Pena, CDPT60922995 Counselor Medicare: Not Enrolled in Medicare Practice Location: 151 N Market Blvd Ste C, Chehalis, WA 98532 Phone: 360-948-0203 Fax: 360-262-6703 | |
Theresa M Normoyle, PHD Counselor Medicare: Accepting Medicare Assignments Practice Location: 2690 Ne Kresky Ave, Chehalis, WA 98532 Phone: 360-330-9595 Fax: 360-330-9560 | |
Stacy Thompson Mueller, BA, CDP Counselor Medicare: Not Enrolled in Medicare Practice Location: 151 Ne Hampe Way Ste C2-1, Chehalis, WA 98532 Phone: 360-748-2274 Fax: 360-748-2276 | |
Amber Arlene Burgess, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1570 N National Ave Ste 216, Chehalis, WA 98532 Phone: 360-763-5828 | |
Ms. Teresa Ann Williams, B.A. Counselor Medicare: Not Enrolled in Medicare Practice Location: 135 W Main St, Chehalis, WA 98532 Phone: 360-748-6696 Fax: 360-748-0627 | |
Troy Achord, Counselor Medicare: Not Enrolled in Medicare Practice Location: 135 W Main St, Chehalis, WA 98532 Phone: 360-748-4339 Fax: 360-496-5039 |