Individual
LAUREN E LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN-PMHNP-BC
Contact information
Practice address
5305 RIVER RD N STE B, KEIZER, OR 97303-5324
(503) 782-8907
(503) 386-3310
Mailing address
PO BOX 14691, PORTLAND, OR 97293-0691
(503) 782-8907
(503) 386-3310
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201340303RN
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201501816NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500683936
—
OR
05
—
500683937
—
OR
Enumeration date
07/01/2013
Last updated
10/25/2023
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