person
Tisha Marie Larsen
Adult Psychiatric/Mental Health Registered Nurse in Roseburg, Oregon
NPI 1578954855

Tisha Marie Larsen is an Adult Psychiatric/Mental Health Registered Nurse based in Roseburg, OR and is specialized in Psychiatric/Mental Health, Adult. Tisha Marie Larsen practices in Roseburg, OR. The NPI Number for Tisha Marie Larsen is 1578954855 and holds a License No. 201500780NP-PP (Oregon).

The current practice location address for Tisha Marie Larsen is 621 W Madrone St, Roseburg, OR and can be reached out via phone at 541-440-3500 and via fax at 541-957-3003. You can also correspond with Tisha Marie Larsen through the mailing address at PO BOX 1121, ROSEBURG, OR - 97470-0254 (mailing address contact number: 541-672-2691).

Location: 621 W Madrone St, Roseburg, OR, 97470-0254
person
Provider Profile Details
NPI Number
1578954855
Provider Name
Tisha Marie Larsen
Credential
Provider Entity Type
Individual
Gender
Female
Address
621 W Madrone St, Roseburg, OR, 97470-0254
Phone Number
541-440-3500
Fax Number
541-957-3003
Provider Enumeration Date
02/09/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
165772 05 OR
institution
Provider Business Practice Location Address Details
Address
621 W Madrone St
City
State
Zip
97470-3090
Phone Number
541-440-3500
Fax Number
541-957-3003
person
Provider Business Mailing Address Details
Address
621 W Madrone St
City
State
Zip
97470-3090
Phone Number
541-440-3500
Fax Number
541-957-3003
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Registered Nurse
Speciality
Psychiatric/Mental Health, Adult
Taxonomy
License No.
201910861NP-PP (Oregon)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
201500780NP-PP (Oregon)
Definition
Definition to come...
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