Individual
KENNETH DAVID LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10180 SE SUNNYSIDE RD, DEPARTMENT OF ANESTHESIOLOGY, CLACKAMAS, OR 97015-8970
(503) 571-4506
Mailing address
10180 SE SUNNYSIDE RD, DEPARTMENT OF ANESTHESIOLOGY, CLACKAMAS, OR 97015-8970
(503) 571-4506
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
OR MD16228
OR
207L00000X
Anesthesiology Physician
WA MD00034710
WA
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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