Individual
GRACE REBECCA LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
418 MAIN ST., BREWSTER, WA 98812
(509) 689-8900
Mailing address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
(509) 689-8900
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP30004121
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0293307
L&I
WA
05
—
1891759411
—
WA
Enumeration date
04/12/2006
Last updated
06/29/2022
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