Individual
SABRA LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2625 SE HAWTHORNE BLVD, PORTLAND, OR 97214-2941
(503) 407-6370
Mailing address
2625 SE HAWTHORNE BLVD, PORTLAND, OR 97214-2941
(503) 407-6370
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L1895
OR
Other
Enumeration date
11/15/2006
Last updated
09/30/2009
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