Individual
ERIC JACOB LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP
Contact information
Practice address
1415 E KINCAID ST, MOUNT VERNON, WA 98274-4126
(360) 424-4111
Mailing address
1415 E KINCAID ST, MOUNT VERNON, WA 98274-4126
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP60956123
WA
Other
Enumeration date
04/30/2019
Last updated
10/06/2021
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