Isaac L Larson RC1

NPI 1144368655 - Counselor - 101YM0800X

NPI Details
NPI 1144368655
Gender Male
Enumeration Date 02/05/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
5023 NE KILLINGSWORTH ST
PORTLAND OR, 97218-1915, US
Phone (503) 402-8117
Fax (503) 284-6585
Business Location
605 SW BONITA RD
APT# K108
LAKE OSWEGO OR, 97035, US
Phone (971) 285-2673
Fax
Toxanomy
Taxonomy Code 101YM0800X
License State
License Number
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According to our database, Isaac L Larson RC1 NPI is 1144368655, taxonomy code is 101YM0800X Isaac L Larson RC1 physically located at 5023 Ne Killingsworth St, Portland OR, 97218-1915. NPI Number Isaac L Larson RC1 has the Individual type.

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1144368655 NPI number is provided on an as is basis without warranty of any kind. 1144368655 is maintained by the National Plan & Provider Enumeration System. The contents of Isaac L Larson RC1 are for informational purposes only.