LARISSA LARA

PORTLAND, OR
NPI1295575454
Entity TypeIndividual
GenderN/A
Sole Proprietor ?Yes
Primary Taxonomy261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)
Enumeration Date2024-05-27
Last Update Date2024-05-27
Business Address
LARISSA LARA
3415 SE POWELL BLVD
PORTLAND, OR 97202-3371
Phone number: 888-295-6996
Mailing Address
LARISSA LARA
3415 SE POWELL BLVD
PORTLAND, OR 97202-3371
Phone number: