Individual
BRANDON LEE LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9330 59TH AVE SW, LAKEWOOD, WA 98499-2858
(253) 881-7020
Mailing address
PO BOX 422, GIG HARBOR, WA 98335-0422
(253) 886-3527
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/11/2010
Last updated
08/11/2010
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