Individual
DR. MEGAN ANN MARIE LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
3857 WOLVERINE ST NE # 16-C, SALEM, OR 97305-4270
(503) 588-1039
Mailing address
3857 WOLVERINE ST NE # 16-C, SALEM, OR 97305-4270
(503) 588-1039
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
23002539A
IN
231H00000X
Audiologist
A.01949
OH
237600000X
Audiologist-Hearing Aid Fitter
Primary
030957
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000888978
ANTHEM
IN
05
—
0110826
—
OH
05
—
201207720
—
IN
Enumeration date
09/10/2013
Last updated
10/18/2019
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