Individual
DR. MARK W LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
716 E MANITOBA AVE, ELLENSBURG, WA 98926-3842
(509) 925-3151
Mailing address
716 E MANITOBA AVE, ELLENSBURG, WA 98926-3842
(509) 925-3151
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2520900035733
WA
207Q00000X
Family Medicine Physician
MD00035733
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8219073
—
WA
Enumeration date
03/20/2006
Last updated
05/15/2025
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