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NPI Code Detail

MEDICARE: KATHRYN LARSSON MSW

MEDICARE:   KATHRYN  LARSSON  MSW
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 CounselorLH00003732WA

General Provider Information

NPI Number : 1780738807
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN LARSSON MSW
Provider Business Mailing Address
First Line : 7245 LAKE ALICE RD SE
Second Line :
City : FALL CITY
State : WA
Zip : 98024-6708
Country : US
Telephone Number : 206-933-1710
Fax Number :
Provider Business Practice Location Address
First Line : 7245 LAKE ALICE RD SE
Second Line :
City : FALL CITY
State : WA
Zip : 98024-6708
Country : US
Telephone Number : 206-933-1710
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2007
Last Update Date : 02/22/2024

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Directions to “ KATHRYN LARSSON MSW” Practice Location

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