Jonathan Mychal Larson
Jonathan Mychal Larson is a Mental Health Counselor in Portland, Oregon. Licensed in Oregon. Registered with an NPI since 2007.
- Licensed in
- OR
- In the registry since
- 2007
Practice location Address checks out
3415 SE Powell BlvdPortland, OR 97202-3371
Phone: (503) 234-9591
Fax: (503) 205-3552
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Mental Health Counselor (primary) | Taxonomy 101YM0800X (OR) |
|---|
Record details
| NPI number | 1619174117 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | June 28, 2007 |
| Last updated in NPPES | July 8, 2007 |
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