Provider Demographics
NPI:1548940281
Name:FRANZINO, LARISSA (SUDPT)
Entity type:Individual
Prefix:
First Name:LARISSA
Middle Name:
Last Name:FRANZINO
Suffix:
Gender:F
Credentials:SUDPT
Other - Prefix:
Other - First Name:LARISSA
Other - Middle Name:
Other - Last Name:KARAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SUDPT
Mailing Address - Street 1:238 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362-6009
Mailing Address - Country:US
Mailing Address - Phone:215-833-8786
Mailing Address - Fax:
Practice Address - Street 1:716 S CHASE ST
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-6122
Practice Address - Country:US
Practice Address - Phone:360-395-2976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61451838101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)