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NPI Code Detail

MEDICARE: LISA ARLENE LARSON

MEDICARE: LISA ARLENE LARSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
21041C0700XClinical Social WorkerLW60491393WA

General Provider Information

NPI Number : 1326193871
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA ARLENE LARSON
Provider Business Mailing Address
First Line : 100 N HOWARD ST STE R
Second Line :
City : SPOKANE
State : WA
Zip : 99201-0508
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 101 ELLIOTT AVE W STE 500
Second Line :
City : SEATTLE
State : WA
Zip : 98119-4292
Country : US
Telephone Number : 206-708-6432
Fax Number : 425-640-9600
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2007
Last Update Date : 10/07/2025

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