Larson, Michael J
Larson, Michael J is an individual health care provider with primary practice located at 11315 Bridgeport Way Sw , Lakewood WA 98499-3004. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Larson, Michael J can be contacted via phone (253) 588-1711.Contact Information
Primary practice address
11315 Bridgeport Way Sw
Lakewood WA 98499-3004
Phone: (253) 588-1711
Fax: (253) 838-6418
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | MD00038582 | Washington |
Profile Details
| NPI number | 1326080573 |
|---|---|
| LBN Legal business name | Larson, Michael J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 12th, 2006 |
| Last updated | Apr 26th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1326080573 | NPPES |
| Washington | Other | 0176597 | LIWA |
| Washington | MEDICAID | 8254039 | LIWA |
| Washington | Other | 2164LA | LIWA |
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