Individual
AMY LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5405 WARBLER LN, WEST RICHLAND, WA 99353-5732
(843) 991-6692
Mailing address
5405 WARBLER LN, WEST RICHLAND, WA 99353-5732
(843) 991-6692
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA60675003
WA
363AS0400X
Surgical Physician Assistant
PA60675003
WA
Other
Enumeration date
09/10/2014
Last updated
07/31/2023
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