Individual
LARISA V KATERENCHUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
417 NW BATTAGLIA AVE, GRESHAM, OR 97030-5260
(971) 998-5424
(503) 666-9653
Mailing address
417 NW BATTAGLIA AVE, GRESHAM, OR 97030-5260
(971) 998-5424
(503) 666-9653
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
200840254RN
OR
Other
Enumeration date
12/04/2008
Last updated
12/04/2008
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