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General NPI Number Information
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NPI Number | 1912284365
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Entity Type | Individual
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Provider Name | MEGAN LARSON LCPO
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Gender | Female
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Dates
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Enumeration Date | 11/14/2011
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Last Update Date | 08/19/2014
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Provider Practice Location Address
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Address Line | 127 SW 156TH ST
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City | BURIEN
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State | WA
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Zip | 98166-2562
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Country | US
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Telephone | 235-216-0777
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Fax | 253-216-0778
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Provider Business Mailing Address
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Address Line | 127 SW 156TH ST
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City | BURIEN
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State | WA
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Zip | 98166-2562
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Country | US
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Telephone | 235-216-0777
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Fax | 253-216-0778
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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 | 222Z00000X
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Taxonomy Name | Orthotist
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License Number | OI 60269456
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 224P00000X
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Taxonomy Name | Prosthetist
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License Number |
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License Number State |
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