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Individual

LARRY EDWIN RAYMOND JASPER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSYD

Contact information

Practice address
22566 SW WASHINGTON ST STE 202, SHERWOOD, OR 97140-7923
(503) 752-0213
Mailing address
22566 SW WASHINGTON ST STE 202, SHERWOOD, OR 97140-7923
(503) 752-0213

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3164
OR

Other

Enumeration date
01/26/2021
Last updated
01/26/2021
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