Individual
JENNIFER ALTA LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
101 W 8TH AVE, SPOKANE, WA 99204-2307
(509) 474-3917
Mailing address
317 E 28TH AVE, SPOKANE, WA 99203-2503
(509) 863-9275
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN00148161
WA
367500000X
Certified Registered Nurse Anesthetist
Primary
AP60289317
WA
Other
Enumeration date
04/26/2012
Last updated
06/20/2012
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