Individual
MICHAEL LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
55 COBURG RD, EUGENE, OR 97401-2433
(541) 485-8111
Mailing address
500 NE MULTNOMAH ST STE 100, PORTLAND, OR 97232-2099
(541) 566-4500
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
174949
OR
Other
Enumeration date
11/18/2015
Last updated
12/28/2021
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