Individual
MR. LARRY GLEN ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ACHT
Contact information
Practice address
1320 SW HALL ST, #203, PORTLAND, OR 97201-3261
(503) 781-6542
Mailing address
1320 SW HALL ST, #203, PORTLAND, OR 97201-3261
(503) 781-6542
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/16/2007
Last updated
08/16/2007
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