Individual
SHANYN LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5331 S MACADAM AVE STE 287, PORTLAND, OR 97239-3849
(503) 635-3416
Mailing address
5331 S MACADAM AVE STE 287, PORTLAND, OR 97239-3849
(503) 635-3416
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OR
Other
Enumeration date
03/19/2026
Last updated
03/19/2026
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