NPI 1093185118

Keith R Larson DMD PC

Organisation Customized Equipment (DME) Beaverton, OR

Practice location

Address: 17895 NW Evergreen Pkwy 130, Beaverton, OR 97006-7402
Phone: (503) 716-6712
Fax: (503) 536-6617

Authorised official

Name: Keith Rodney Larson
Title: Owner
Phone: (503) 292-0416

Registered specialties

Customized Equipment (DME) Primary

Suppliers Taxonomy 332BC3200X Licence D4338 (OR)

Other Durable Medical Equipment & Medical Supplies providers in Oregon →

Registry record

NPI: 1093185118
Entity type: Organization
NPI issued: 1 Oct 2015
Record last updated: 20 Oct 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.