Nelson, Larry Ralph

Nelson, Larry Ralph is an individual health care provider with primary practice located at 809 S 15Th St , Mount Vernon WA 98274-4564. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Nelson, Larry Ralph can be contacted via phone (360) 428-6434.

Contact Information

Primary practice address
809 S 15Th St Mount Vernon WA 98274-4564
Phone: (360) 428-6434
Fax: (360) 428-6485
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X MD00013912 Washington

Profile Details

NPI number 1477510493
LBN Legal business name Nelson, Larry Ralph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2006
Last updated Jul 8th, 2007 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477510493 NPPES
Washington MEDICAID 8167603

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