Marlia-Larsen, Lori Jo

Marlia-Larsen, Lori Jo is an individual health care provider with primary practice located at 221 W Stewart Ave Ste 101 , Medford OR 97501-3609. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife. Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife is her primary health care specialty. Marlia-Larsen, Lori Jo can be contacted via phone (541) 690-3555.

Contact Information

Primary practice address
221 W Stewart Ave Ste 101 Medford OR 97501-3609
Phone: (541) 690-3555
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 200942263RN Oregon
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X 201602517NP-PP Oregon

Profile Details

NPI number 1114260650
LBN Legal business name Marlia-Larsen, Lori Jo
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 3rd, 2013
Last updated Jan 10th, 2020 - about 5 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 1114260650 NPPES
Oregon Other 201602517NP-PP OREGON STATE BOARD OF NURSING
Oregon Other 200942263RN OREGON STATE BOARD OF NURSING

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