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Individual

CYNTHIA M LARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMP

Contact information

Practice address
11821 NE 128TH ST STE B, KIRKLAND, WA 98034-7210
(425) 814-2800
(425) 823-0882
Mailing address
13044 111TH AVE NE, KIRKLAND, WA 98034-6306
(206) 799-2562

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00007116
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0182278
WA DEPT OF L&I
WA
01
REGENCE
7695LA
WA
Enumeration date
01/04/2007
Last updated
07/08/2007
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