MEDICARE: LARRY S FREEMAN 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
1	2084P0804X	Child & Adolescent Psychiatry Physician	MD00016788	WA

Other Identifiers

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

General Provider Information

NPI Number	:	1609956564
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARRY S FREEMAN MD

Provider Business Mailing Address
First Line	:	119 N COMMERCIAL ST
Second Line	:	SUITE 1360
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-4446
Country	:	US
Telephone Number	:	360-752-5527
Fax Number	:	360-752-5543

Provider Business Practice Location Address
First Line	:	119 N COMMERCIAL ST
Second Line	:	SUITE 1360
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-4446
Country	:	US
Telephone Number	:	360-752-5527
Fax Number	:	360-752-5543

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	07/08/2007

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