Individual
DR. MICHELE TERESA LARAIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, PMHNP
Contact information
Practice address
1715 E BURNSIDE ST, PORTLAND, OR 97214-1531
(503) 234-4622
(503) 788-6399
Mailing address
7107 SW LA VIEW DR, PORTLAND, OR 97219-3003
(503) 449-6658
Taxonomy
Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
Primary
—
OR
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
—
OR
Other
Enumeration date
05/13/2007
Last updated
09/11/2025
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