Individual
LARRY DEAN BECKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRM, THW
Contact information
Practice address
7916 SE FOSTER RD, PORTLAND, OR 97206-4289
(503) 465-2749
Mailing address
PO BOX 16576, PORTLAND, OR 97292-0576
(503) 465-2749
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/23/2020
Last updated
08/14/2020
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