Individual
MS. LARISSA CHRISTINE IENNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
500 N COLUMBIA RIVER HWY, SAINT HELENS, OR 97051-1299
(503) 397-0471
(503) 366-5519
Mailing address
1040 NW 22ND AVE #520, PORTLAND, OR 97210
(503) 413-7557
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
200340678
OR
363LF0000X
Family Nurse Practitioner
Primary
200850116
OR
Other
Enumeration date
08/27/2007
Last updated
02/21/2017
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