Jonathan Mychal Larson is a mental health counselor in Portland, OR. Jonathan Mychal Larson NPI is 1619174117. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
3415 SE POWELL BLVD
PORTLAND, OR
ZIP 97202-371
Phone: (503) 234-9591
Fax: (503) 205-3552
The enumeration date for this NPI number is 6/28/2007 and was last updated on 7/8/2007.