Individual
MRS. SARA LOUISE LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A.T.,C.
Contact information
Practice address
1316 5TH ST, SNOHOMISH, WA 98290-2712
(360) 563-4085
Mailing address
9131 190TH AVE SE, SNOHOMISH, WA 98290-3219
(360) 568-2770
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
880940
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
880940
NATA MEMBER NUMBER
WA
Enumeration date
09/23/2006
Last updated
07/08/2007
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