MR. KENNETH DALE LARSON (NPI# 1487168977) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487168977 |
| Entity Type | Individual |
| Full Name | MR. KENNETH DALE LARSON |
| Credential | COUNSELOR CIT |
| Practice Address |
6601 Ne 78th Ct Ste A3 Portland OR 97218-2823 |
| Mailing Address |
33565 Ruby Ln Saint Helens OR 97051-3622 |
| Practice Telephone | 5035253949 |
| Mailing Telephone | 5754425668 |
| Enumeration Date | 2017-11-21 |
| Last Update Date | 2017-11-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952462384 | Kenneth G Larson | Optometrist | 4580 State St, Green Acres Plaza, Saginaw, MI 48603-3803 | 2006-12-12 |
| 1891806675 | Kenneth L. Larson | Psychologist | 1891 E Roseville Pkwy Ste 100, Roseville, CA 95661-7974 | 2006-08-31 |
| 1629051974 | Kenneth Duane Larson | Pharmacist | 603 S Chestnut St, Ellensburg, WA 98926-3875 | 2005-11-21 |
| 1043379829 | Kenneth B Larson | Physician Assistant | 1600 S 20th Ave, Safford, AZ 85546-4011 | 2006-12-07 |
| 1174691836 | Kenneth Craig Larson | Dentist | 2860 Piedmont Ave, Duluth, MN 55811-2938 | 2006-12-01 |
| 1689741795 | Kenneth W. Larson | Surgery | 1900 S National Ave, Suite 1950, Springfield, MO 65804-2265 | 2006-11-30 |
| 1659451441 | Kenneth Andrew Larson | Surgery | 5511 S Congress Ave, Suite 105, Atlantis, FL 33462-1140 | 2006-10-16 |
| Street Address |
6601 NE 78TH CT STE A3 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97218-2823 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174927115 | Amber Walker | Counselor | 6601 Ne 78th Ct Ste A3, Portland, OR 97218-2823 | 2014-10-20 |
| 1043820707 | Maurice Golden | Counselor | 6601 Ne 78th Ct Ste A3, Portland, OR 97218-2823 | 2020-08-06 |
| 1093323396 | Jeremy Eckard | Counselor | 6601 Ne 78th Ct Ste A3, Portland, OR 97218-2823 | 2020-07-22 |
| 1669093944 | Elizabeth Hendrickson | Licensed Practical Nurse | 6601 Ne 78th Ct Ste A3, Portland, OR 97218-2823 | 2020-04-28 |
| 1144841420 | Andrea Nicolet | Licensed Practical Nurse | 6601 Ne 78th Ct Ste A3, Portland, OR 97218-2823 | 2020-04-28 |
| 1801421789 | Kala Mcmillan | Counselor | 6601 Ne 78th Ct Ste A3, Portland, OR 97218-2823 | 2020-03-11 |
| 1902438187 | Keelani Duffey | Licensed Practical Nurse | 6601 Ne 78th Ct Ste A3, Portland, OR 97218-2823 | 2020-02-06 |
| 1528690716 | Patricia Humphrey | Licensed Practical Nurse | 6601 Ne 78th Ct Ste A3, Portland, OR 97218-2823 | 2020-02-06 |
| 1508400169 | Nina Tran | Registered Nurse | 6601 Ne 78th Ct Ste A3, Portland, OR 97218-2823 | 2019-11-06 |
| 1215570668 | Alice Cortez | Licensed Practical Nurse | 6601 Ne 78th Ct Ste A3, Portland, OR 97218-2823 | 2019-10-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043852726 | Alex Margarito | Specialist/Technologist | 6801 Necornfoot Rd, Fpo, AA 97218 | 2019-10-14 |
| 1083101943 | Joyce M Larkins | Specialist | 5852 Ne 42nd Ave., Portland, OR 97218 | 2018-04-17 |
| 1740709658 | Alyssa M Cavalier | Licensed Practical Nurse | 6601 Ne 78th Ct., Suite A3, Portland, OR 97218 | 2017-09-12 |
| 1093266405 | Jean Hansen | Counselor | 6601ne 78th Court Suite, Suite A3, Portland, OR 97218 | 2016-10-20 |
| 1174913636 | Kirsten Kelly-chambers | Counselor | 4310 Ne Killinsworth Street, Portland, OR 97218 | 2015-02-04 |
| 1386962074 | Kathleen Kuhlmey Sheridan | Nurse Practitioner | 5215 Ne 52nd Ave, Portland, OR 97218 | 2010-05-06 |
| 1003049909 | Kevin Richardson | Adult Companion | 5029 Ne Killingsworth St, Portland, OR 97218 | 2009-08-26 |
| 1366676462 | Bobbi Gabriele Kennedy | Military Health Care Provider | 6801 Ne Cornfoot Road, Portland, OR 97218 | 2009-05-05 |
| 1396980751 | Jamie Mercile Taylor | Counselor | 4310 N.e Kilingsworth, Portland, OR 97218 | 2008-12-12 |
| 1902041460 | Brandi Danielle Hess | Counselor | 4450 Ne 76th, Portland, OR 97218 | 2008-12-11 |
| Find all providers in zip 97218 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477163657 | Kevin Charles Reiser | Counselor | 2318 Ne Martin Luther King Blvd, Portland, OR 97212-3715 | 2020-08-03 |
| 1881203628 | Beau Curtiss | Counselor | 7916 Se Foster Rd Ste 203, Portland, OR 97206-4289 | 2020-07-28 |
| 1851916886 | Jonathan Cross | Counselor | 49 Montrose Ave Apt 3, Portland, ME 04103-2442 | 2020-06-16 |
| 1639703960 | Elizabeth Ann Anderson | Counselor | 1820 Sw Vermont St Ste J, Portland, OR 97219-1945 | 2020-02-25 |
| 1194356618 | Deforrest Kwesi Jackson | Counselor | 122 Ne 122nd Ave Ste 200, Portland, OR 97230-2103 | 2020-02-03 |
| 1760012942 | Jesse Decker | Counselor | 7015 N Boston Ave, Portland, OR 97217-5711 | 2020-01-16 |
| 1740829076 | Ryan Christianson | Counselor | 2707 Ne Flanders St, Portland, OR 97232-3159 | 2020-01-03 |
| 1083264477 | Kayla Rose Paris | Counselor | 420 Cumberland Ave, Portland, ME 04101-2823 | 2019-09-17 |
| 1275193260 | Anna Khval | Counselor | 1500 Se 122nd Ave, Portland, OR 97233-1207 | 2019-06-20 |
| 1841855301 | Portland Opioid Health Home | Counselor | 48 Free St., Mezzanine Level, Portland, ME 04101 | 2019-05-09 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.