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Individual

LARENDA GAYLE PEREZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSS

Contact information

Practice address
12360 E BURNSIDE ST, PORTLAND, OR 97233-1042
(971) 279-4800
(971) 279-2051
Mailing address
211 SE CARUTHERS ST, PORTLAND, OR 97214-4502
(503) 224-1044
(971) 260-0355

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
111906
OR

Other

Enumeration date
03/07/2025
Last updated
03/07/2025
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