Individual
TANYA RENE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
120 N. OAK ST, BURLINGTON, WA 98233
(425) 319-6809
(360) 755-1305
Mailing address
120 N. OAK ST., BURLINGTON, WA 98233
(425) 319-6809
(360) 755-1305
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00020919
WA
Other
Enumeration date
11/21/2007
Last updated
12/16/2014
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