Individual
MADELINE JEAN LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
4205 NE 130TH AVE, VANCOUVER, WA 98682-6855
(360) 448-8419
Mailing address
4205 NE 130TH AVE, VANCOUVER, WA 98682-6855
(360) 448-8419
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H7313
OR
Other
Enumeration date
10/14/2016
Last updated
10/14/2016
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