Individual
GRETA KATHERINE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
440 NW DIVISION ST, GRESHAM, OR 97030-5506
(503) 215-9500
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201391240NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500660728
—
OR
Enumeration date
11/12/2009
Last updated
03/19/2021
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