Individual
CAROL JEAN LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP/SAMP
Contact information
Practice address
832 VALLEY MALL PKWY, SUITE A, EAST WENATCHEE, WA 98802-4496
(509) 670-1000
(509) 884-4100
Mailing address
832 VALLEY MALL PKWY, SUITE A, EAST WENATCHEE, WA 98802-4496
(509) 670-1000
(509) 884-4100
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00023387
WA
Other
Enumeration date
06/06/2008
Last updated
06/06/2008
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