Individual
LARISSA QUADRACCI MATTEI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
510 8TH AVE NE STE 200, ISSAQUAH, WA 98029-5436
(253) 392-3030
(425) 392-2564
Mailing address
510 8TH AVE NE STE 320, ISSAQUAH, WA 98029-5436
(253) 392-3030
(425) 392-2564
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA60715586
WA
363AS0400X
Surgical Physician Assistant
Primary
PA60715586
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2078341
—
WA
Enumeration date
12/07/2016
Last updated
05/13/2024
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