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Individual

DR. AMANDA CELEST ROOF LARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
315 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-4234
(253) 403-1000
Mailing address
315 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-4234
(253) 403-1000

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
43587
IA
207X00000X
Orthopaedic Surgery Physician
65700
WI
207X00000X
Orthopaedic Surgery Physician
MD60482537
WA
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
MD60482537
WA

Other

Enumeration date
03/30/2010
Last updated
02/27/2019
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