Individual
LEEANNA LARISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
913 NW GARDEN VALLEY BLVD, ROSEBURG, OR 97471-6523
(541) 440-1000
Mailing address
913 NW GARDEN VALLEY BLVD, ROSEBURG, OR 97471-6523
(845) 594-4919
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
09/21/2022
Last updated
09/21/2022
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