Individual
ANDREA LYNN LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
5441 S MACADAM AVE STE N, PORTLAND, OR 97239-6106
(503) 583-4048
Mailing address
5441 S MACADAM AVE STE N, PORTLAND, OR 97239-6106
(503) 583-4048
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
C7187
OR
Other
Enumeration date
04/18/2019
Last updated
01/03/2025
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