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General NPI Number Information
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NPI Number | 1801974076
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Entity Type | Individual
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Provider Name | STEVEN LARSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 01/06/2017
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Provider Practice Location Address
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Address Line | 1112 6TH AVE STE 200
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City | TACOMA
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State | WA
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Zip | 98405-4040
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Country | US
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Telephone | 253-272-8664
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Fax | 253-627-7880
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Provider Business Mailing Address
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Address Line | 1112 6TH AVE STE 200
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City | TACOMA
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State | WA
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Zip | 98405-4040
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Country | US
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Telephone | 253-272-8664
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Fax | 253-627-7880
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 42882-020
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MD60041838
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License Number State | WA
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