Individual
ELIZABETH LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MACOM, LAC
Contact information
Practice address
1308 NW 20TH AVE STE 10, PORTLAND, OR 97209-1607
(503) 218-3737
Mailing address
1823 SW MOSS ST, PORTLAND, OR 97219-2742
(831) 419-9590
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC190005
OR
Other
Enumeration date
10/29/2018
Last updated
10/29/2018
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