Individual
MR. BRYAN DUANE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP-PMHNP
Contact information
Practice address
210 GOVERNMENT ROAD, MATTAWA, WA 99349-0906
(509) 932-4499
(509) 932-5363
Mailing address
PO BOX 1581, MATTAWA, WA 99349-0960
(509) 932-4119
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP60980845
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2144830
—
WA
Enumeration date
07/25/2019
Last updated
07/18/2023
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