Provider Demographics
NPI:1164855052
Name:JAMES, LARRY LAVERNE
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:LAVERNE
Last Name:JAMES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:965 TUCKER RD
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-9591
Mailing Address - Country:US
Mailing Address - Phone:541-436-0331
Mailing Address - Fax:541-386-3071
Practice Address - Street 1:965 TUCKER RD
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-9591
Practice Address - Country:US
Practice Address - Phone:541-436-0331
Practice Address - Fax:541-386-3071
Is Sole Proprietor?:No
Enumeration Date:2013-08-14
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional