Individual
LARRISHA WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1920 NW AMBERGLEN PKWY, SUITE 150, BEAVERTON, OR 97006-6980
(971) 327-4355
Mailing address
PO BOX 910544, LEXINGTON, KY 40591-0544
(859) 410-8550
(859) 223-0642
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Enumeration date
01/14/2013
Last updated
01/24/2013
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