LARSTON PETTICORD

PORTLAND, OR
NPI1871889261
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2011-06-23
Last Update Date2019-10-02
Business Address
Mr. LARSTON PETTICORD MS, LPC
3419 NE SANDY BLVD
PORTLAND, OR 97232-1959
Phone number: 503-914-6199
Mailing Address
Mr. LARSTON PETTICORD MS, LPC
11626 NE EVERETT ST
PORTLAND, OR 97220-2362
Phone number: 503-914-6199
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