Individual
DR. WILL LARISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9205 SW BARNES RD, PORTLAND, OR 97225-6603
(503) 216-4830
(503) 216-4850
Mailing address
PO BOX 25180, PORTLAND, OR 97298-0180
(503) 797-6356
(503) 292-0346
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
192524
OR
2085R0202X
Diagnostic Radiology Physician
Primary
63933
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500761504
—
OR
Enumeration date
06/14/2013
Last updated
06/25/2019
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