Individual
JOSHUA LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6400 SE LAKE RD STE 175, PORTLAND, OR 97222-2137
(628) 250-7500
Mailing address
2004 SW JEFFERSON ST APT 504, PORTLAND, OR 97201-6130
(760) 221-5192
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/18/2023
Last updated
09/18/2023
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