Individual
ALYSIA MARIE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2727 HOLLYCROFT ST STE 410, GIG HARBOR, WA 98335-1369
(253) 358-4002
(253) 358-4015
Mailing address
7308 BRIDGEPORT WAY W STE 201, LAKEWOOD, WA 98499-8000
(253) 582-7257
(253) 582-1617
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
PA61601163
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2303843
—
WA
Enumeration date
09/02/2024
Last updated
12/10/2024
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