Individual
ANGELA G LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1211 MERRIAM ST, DAVENPORT, WA 99122-8654
(509) 725-3001
(509) 725-1609
Mailing address
165 E HAWTHORNE AVE, COLVILLE, WA 99114-2629
(509) 684-4597
(509) 684-5286
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
MC61099017
WA
Other
Enumeration date
10/12/2020
Last updated
10/12/2020
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