Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tisha Marie Larsen

Individual provider Family Nurse Practitioner · NPI 1578954855

Tisha Marie Larsen is a Nurse Practitioner in Roseburg, Oregon. Qualified in 2014, 12 years ago. Practices with Adapt, a 43-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
12
Licensed in
OR
In the registry since
2015
Specialties on file
2
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Practice location Address checks out

621 W Madrone St
Roseburg, OR 97470-3090
Phone: (541) 440-3500
Fax: (541) 957-3003
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Psychiatric/Mental Health Registered Nurse (primary) Taxonomy 163WP0809X · Licence 201910861NP-PP (OR)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 201500780NP-PP (OR)

Record details

NPI number1578954855
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 9, 2015
Last updated in NPPESOctober 12, 2021
Certification dateOctober 12, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Adapt — 43 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Roseburg