Individual
ILSE A LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3181 SW SAM JACKSON PARK ROAD, PORTLAND, OR 97239-3098
(503) 494-6513
(503) 494-1542
Mailing address
2330 POST ST, STE 320, SAN FRANCISCO, CA 94115-3466
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A103087
CA
208000000X
Pediatrics Physician
MD167663
OR
Other
Enumeration date
04/15/2008
Last updated
01/21/2020
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