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NPI Code Detail

MEDICARE: LARS CRABO MD

MEDICARE:   LARS  CRABO  MD
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
12085R0202XDiagnostic Radiology Physician28162WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568468890
Entity Type Code : Individual
Provider Name (Legal Business Name) : LARS CRABO MD
Provider Business Mailing Address
First Line : 2930 SQUALICUM PKWY
Second Line : STE B10
City : BELLINGHAM
State : WA
Zip : 98225-1854
Country : US
Telephone Number : 360-733-0430
Fax Number : 360-733-0438
Provider Business Practice Location Address
First Line : 2901 SQUALICUM PKWY
Second Line :
City : BELLINGHAM
State : WA
Zip : 98225-1851
Country : US
Telephone Number : 360-734-5400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 07/08/2007

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Directions to “ LARS CRABO MD” Practice Location

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