Individual
LAWRENCE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
316 MARTIN LUTHER KING JR WAY, 212, TACOMA, WA 98405
(253) 383-5777
(253) 627-0855
Mailing address
316 MARTIN LUTHER KING JR WAY, 212, TACOMA, WA 98405
(253) 383-5777
(253) 627-0855
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
OP00000821
WA
2080P0201X
Pediatric Allergy/Immunology Physician
OP00000821
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10255717
—
WA
Enumeration date
10/05/2006
Last updated
09/21/2012
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