Individual
AARON JOHN LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADC1
Contact information
Practice address
1631 SW COLUMBIA ST, PORTLAND, OR 97201-6025
(503) 231-2641
Mailing address
900 NE 149TH ST, VANCOUVER, WA 98685-1326
(360) 989-4425
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
15-12-23U
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15-12-23U
CADC1
OR
Enumeration date
02/19/2016
Last updated
02/19/2016
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