Provider Demographics
NPI:1851643605
Name:LAROSA, VALERIE (ND)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:LAROSA
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:827 NE ALBERTA ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97211-4578
Mailing Address - Country:US
Mailing Address - Phone:503-477-6670
Mailing Address - Fax:503-766-5979
Practice Address - Street 1:827 NE ALBERTA ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97211-4578
Practice Address - Country:US
Practice Address - Phone:503-477-6670
Practice Address - Fax:503-766-5979
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-03
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1901175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath