Individual
STEVEN KENNETH LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SLP
Contact information
Practice address
1309 NE 27TH ST, MCMINNVILLE, OR 97128-2399
(503) 472-4678
Mailing address
16690 SW MATADOR LN APT SUITE, PORTLAND, OR 97224-2150
(602) 517-7017
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
17126
OR
Other
Enumeration date
08/16/2024
Last updated
08/16/2024
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