Mark W Larson is a Specialist in Ellensburg, Washington. Mark W Larson practices all healthcare services and medical treatments related to Specialist. The NPI Number for Mark W Larson is 1194784090. The last update date is 2010-03-23.
Mark W Larson's current location address is 716 E Manitoba Ave, Ellensburg, Washington. You can contact this provider via phone number 5099253151. The mailing address for Mark W Larson is 716 E Manitoba Ave, Ellensburg, Washington. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mark W Larson |
|---|---|
| Address | 716 E Manitoba Ave, Ellensburg, Washington |
| Phone Number | 5099253151 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1194784090 |
|---|---|
| Provider Enumeration Date | 2006-03-20 |
| Last Updated Date | 2010-03-23 |
Provider Mailing Address Detail
| Address | 716 E Manitoba Ave |
|---|---|
| City | Ellensburg |
| State | Washington (WA) |
| Post Code | 989263842 |
| Phone Number | 5099253151 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | 252090003573 |
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Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 8219073 | WA | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Mark W Larson by the Centers for Medicare & Medicaid Services?
The Mark W Larson has been issued the NPI (National Provider Identifier) 1194784090 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you provide the complete physical address where Mark W Larson is located?
The Mark W Larson is situated at the following address: 716 E Manitoba Ave, Ellensburg, WA, 989263842.
What is Mark W Larson's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Mark W Larson is Specialist, and the taxonomy code that categorizes this field of expertise is 174400000X.
On what date did the Mark W Larson receive the assignment of its 1194784090 from the Centers for Medicare & Medicaid Services?
The Mark W Larson was issued its 1194784090 by the Centers for Medicare & Medicaid Services on 2006-03-20.
As of what date were the details related to Mark W Larson most recently updated or revised?
The information pertaining to Mark W Larson, including its address, specialty, and other relevant details, was last updated or revised on 2010-03-23.
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