Individual
KELLY KRISTINE LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
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
OD00003987
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2031367
—
WA
Enumeration date
06/17/2006
Last updated
07/31/2015
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