Individual
AUDREY L. LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
2505 N 45TH ST, SEATTLE, WA 98103-6909
(206) 632-5500
Mailing address
10501 8TH AVE NE APT 330, SEATTLE, WA 98125-7241
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00013566
WA
Other
Enumeration date
01/22/2007
Last updated
07/08/2007
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