Individual
MICHAEL W LARY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
HS
Contact information
Practice address
COMDT (CG-1122), U.S. COAST GUARD, 2100 2ND ST SW, SUITE 5314, WASHINGTON, DC 20593-0001
(503) 861-6244
(503) 861-6358
Mailing address
PO BOX 1222, ASTORIA, OR 97103-1222
(503) 470-0302
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
12/16/2005
Last updated
07/08/2007
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