Individual
DREW LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4315 SE WOODSTOCK BLVD, PORTLAND, OR 97206-6269
(503) 771-1881
Mailing address
0408 SW NEBRASKA ST, PORTLAND, OR 97239-3535
(541) 221-2918
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0015530
OR
Other
Enumeration date
10/06/2016
Last updated
10/06/2016
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