Individual
DR. LARRY THOMAS BALENTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
259 HUNT RD, PORT ANGELES, WA 98363-9657
(360) 525-4646
Mailing address
259 HUNT RD, PORT ANGELES, WA 98363-9657
(360) 525-4646
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD60036029
WA
207RR0500X
Rheumatology Physician
MD 60036029
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
027313
—
OR
05
—
2205193
—
WA
Enumeration date
10/03/2006
Last updated
12/20/2024
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