Individual
DR. MICHAEL CARL LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 9TH AVE, SEATTLE, WA 98101-2756
(206) 223-2319
(206) 223-6379
Mailing address
1100 9TH AVE, MS:M4-PFS, SEATTLE, WA 98101-2756
(206) 515-5811
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A97376
CA
207RG0100X
Gastroenterology Physician
Primary
MD60295858
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0299294
LABOR AND INDUSTRY
WA
01
—
1962685222
MONTANA MEDICAID
WA
05
—
1962685222
—
WA
01
—
MD00307
AK MEDICAID
AK
Enumeration date
12/10/2007
Last updated
06/18/2013
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