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General NPI Number Information
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NPI Number | 1043534878
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Entity Type | Individual
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Provider Name | MATTHEW GOLDEN LARSON D.C.
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Gender | Male
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Dates
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Enumeration Date | 03/23/2010
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Last Update Date | 05/03/2021
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Provider Practice Location Address
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Address Line | 23515 NE NOVELTY HILL RD STE B225
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City | REDMOND
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State | WA
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Zip | 98053-2073
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Country | US
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Telephone | 425-898-8000
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Fax | 425-898-8005
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Provider Business Mailing Address
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Address Line | 36015 SE 96TH WAY
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City | SNOQUALMIE
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State | WA
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Zip | 98065-9218
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Country | US
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Telephone | 425-898-3055
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Fax | 425-898-8005
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH00033791
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License Number State | WA
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