Individual
MR. LARRY WOLFE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
9500 SW BARBUR BLVD, SUITE 106, PORTLAND, OR 97219-5466
(503) 980-5327
Mailing address
9500 SW BARBUR BLVD, SUITE 106, PORTLAND, OR 97219-5466
(503) 980-5327
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
10854
OR
Other
Enumeration date
04/27/2012
Last updated
04/27/2012
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