Healthcare Provider Details

I. General information

NPI: 1235072216
Provider Name (Legal Business Name): JULIE LARSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

665 N RIVERPOINT BLVD
SPOKANE WA
99202-1648
US

IV. Provider business mailing address

412 E SPOKANE FALLS BLVD NUTRITION AND EXERCISE PHYSIOLOGY
SPOKANE WA
99202-2131
US

V. Phone/Fax

Practice location:
  • Phone: 509-389-5844
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code224Y00000X
TaxonomyClinical Exercise Physiologist
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: