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Individual

DAVID P LARSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
16043 SW WAXWING WAY, BEAVERTON, OR 97007-8362
(503) 715-3414
(503) 352-4775
Mailing address
6650 SW REDWOOD LN STE 380, PORTLAND, OR 97224-7169
(503) 715-3414
(503) 352-4775

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
34056
AZ
207R00000X
Internal Medicine Physician
Primary
MD29034
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500605904
OR
Enumeration date
08/30/2005
Last updated
08/05/2021
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