Individual
LARISSA BIRNDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, PMHNP-BC
Contact information
Practice address
2701 NW VAUGHN ST STE 470, PORTLAND, OR 97210-5326
(503) 719-4648
Mailing address
2873 NW RALEIGH ST, PORTLAND, OR 97210-2464
(503) 679-7824
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201393260RN
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201504586NP-PP
OR
Other
Enumeration date
03/12/2014
Last updated
09/06/2023
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