Individual
CHARLES EVERT LARSSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
528 MYRTLE AVENUE, LA CONNER, WA 98257
(360) 466-3136
Mailing address
P O BOX 1620, LACONNER, WA 98862-1620
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00022768
WA
Other
Enumeration date
02/22/2012
Last updated
02/22/2012
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