Individual
LARYSSA SOPHIA LITEPLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1015 NW 22ND AVE, PORTLAND, OR 97210-3025
(503) 413-7260
Mailing address
1015 NW 22ND AVE, PORTLAND, OR 97210-3025
(917) 952-8729
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
61379599
WA
363LF0000X
Family Nurse Practitioner
Primary
10002063
OR
Other
Enumeration date
11/08/2022
Last updated
01/07/2026
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