Individual
WENDY LEE LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
6274 SW CAPITOL HWY, PORTLAND, OR 97239-2674
(503) 246-3283
Mailing address
6274 SW CAPITOL HWY, PORTLAND, OR 97239-2674
(503) 246-3283
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2525
OR
Other
Enumeration date
12/14/2005
Last updated
11/17/2007
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