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1114625233
LARISSA RENE MCCULLOUGH
PORTLAND, OR
NPI
1114625233
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2023-02-17
Last Update Date
2026-06-30
Business Address
LARISSA RENE MCCULLOUGH
1904 SE DIVISION ST
PORTLAND, OR 97202-1146
Phone number: 503-517-8663
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Mailing Address
LARISSA RENE MCCULLOUGH
1904 SE DIVISION ST
PORTLAND, OR 97202-1146
Phone number: 503-517-8663
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