MEDICARE: LARA WELFORD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	L16067	OR

General Provider Information

NPI Number	:	1346822624
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARA WELFORD

Provider Business Mailing Address
First Line	:	82682 RIVER DR
Second Line	:
City	:	CRESWELL
State	:	OR
Zip	:	97426-9399
Country	:	US
Telephone Number	:	541-200-0826
Fax Number	:	541-225-5271

Provider Business Practice Location Address
First Line	:	1712 WALNUT ST
Second Line	:
City	:	LA GRANDE
State	:	OR
Zip	:	97850-1555
Country	:	US
Telephone Number	:	541-200-0826
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2021
Last Update Date	:	03/23/2026

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Directions to “ LARA WELFORD ” Practice Location

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