Larsen, John Bryon

Larsen, John Bryon is an individual health care provider with primary practice located at 805 Ne Reservoir Ln , Toledo OR 97391-1335. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Larsen, John Bryon can be contacted via phone (541) 336-2254.

Contact Information

Primary practice address
805 Ne Reservoir Ln Toledo OR 97391-1335
Fax: (541) 336-1803
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1790924264
LBN Legal business name Larsen, John Bryon
Credentials B.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 6th, 2009
Last updated Feb 6th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790924264 NPPES
Oregon Other 93-0698327 PRIVATE NONPROFIT

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