Individual
LARRY STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1601 E FOURTH PLAIN BLVD BLDG 17, VANCOUVER, WA 98661-3717
(360) 397-8246
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
CG60738009
WA
372600000X
Adult Companion
—
—
Other
Enumeration date
06/16/2014
Last updated
08/07/2023
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