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Individual

PAUL ROBERT LARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
100 HIGHLINE DR, EAST WENATCHEE, WA 98802-5341
(509) 884-0641
Mailing address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R1340646
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1629134960
WA
01
316364
L&I
WA
Enumeration date
12/29/2006
Last updated
06/29/2022
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