Individual
DOMINIQUE D LARON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3101 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3009
(503) 221-3424
(503) 221-3490
Mailing address
3101 JACKSON PARK RD., PORTLAND, OR 97239
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD195426
OR
207XP3100X
Pediatric Orthopaedic Surgery Physician
MD195426
OR
Other
Enumeration date
04/16/2012
Last updated
10/13/2020
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