Individual
DR. BRAD WALTER LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
3050 SE DIVISION ST STE 215, PORTLAND, OR 97202-1451
(503) 715-5468
(503) 715-5469
Mailing address
3050 SE DIVISION ST STE 215, PORTLAND, OR 97202-1451
(503) 715-5468
(503) 715-5469
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2269
OR
103TC0700X
Clinical Psychologist
2269
OR
Other
Enumeration date
09/24/2008
Last updated
07/12/2023
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