Individual
JEFFREY A LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
720 BIRCHWOOD AVE, BELLINGHAM, WA 98225-1714
(360) 733-1720
(360) 733-0109
Mailing address
PO BOX 5566, BELLINGHAM, WA 98227-5566
(360) 733-1720
(360) 733-0109
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1377TX
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2027829
—
WA
01
—
DH0545
RAILROAD MEDICARE
WA
Enumeration date
03/01/2007
Last updated
05/14/2014
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