Individual
DR. TIMOTHY LEIGH LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19020 33RD AVE W STE 210, LYNNWOOD, WA 98036-4748
(425) 563-1500
(425) 563-1501
Mailing address
19020 33RD AVE W STE 210, LYNNWOOD, WA 98036-4748
(425) 563-1500
(425) 563-1374
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
MD00024859
WA
2085R0202X
Diagnostic Radiology Physician
MD00024859
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0369895
L&I-RADIA REST OF WA
WA
01
—
0369896
L&I-RADIA KING COUNTY
WA
01
—
0369897
L&I-SWEDISH RADIA EDMONDS
WA
01
—
0369898
L&I-EVERGREEN RADIA
WA
01
—
0384450
L&I-SOUTH SOUND RADIOLOGY
WA
05
—
1016017
—
WA
05
—
8123259
—
WA
Enumeration date
06/27/2006
Last updated
03/29/2019
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