Individual
DR. JAIME LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
12555 SW 3RD ST, BEAVERTON, OR 97005-0517
(503) 928-4275
Mailing address
15569 SW STONE RIDGE CIR, BEAVERTON, OR 97007-6698
(503) 679-5135
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
2625
OR
103TC0700X
Clinical Psychologist
25759
CA
103TC0700X
Clinical Psychologist
Primary
2625
OR
Other
Enumeration date
05/14/2015
Last updated
04/23/2021
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