TISHA MARIE LARSEN

ROSEBURG, OR
NPI1578954855
Professional NameTISHA LARSEN
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy163WP0809X Registered Nurse, Psych/Mental Health, Adult
(Licence: OR  201910861NP-PP)
Additional Taxonomies363LF0000X Nurse Practitioner, Family
(Licence: OR  201500780NP-PP)
Enumeration Date2015-02-09
Last Update Date2021-10-12
Business Address
TISHA MARIE LARSEN
621 W MADRONE ST
ROSEBURG, OR 97470-3090
Phone number: 541-440-3500
Mailing Address
TISHA MARIE LARSEN
PO BOX 1121
ROSEBURG, OR 97470-0254
Phone number: 541-672-2691