Healthcare Provider Details

I. General information

NPI: 1669835203
Provider Name (Legal Business Name): JANE LARRIMORE M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2016
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3425 13TH ST
BAKER CITY OR
97814-1340
US

IV. Provider business mailing address

3425 13TH ST
BAKER CITY OR
97814-1340
US

V. Phone/Fax

Practice location:
  • Phone: 541-523-7400
  • Fax: 541-523-4927
Mailing address:
  • Phone: 541-523-7400
  • Fax: 541-523-4927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number26-QMHPC-001788
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: