MEDICARE: LARISSA BRAGA BEASON

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	363A00000X	Physician Assistant	0110011645	VA

General Provider Information

NPI Number	:	1831909365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARISSA BRAGA BEASON

Provider Business Mailing Address
First Line	:	3600 S GLEBE RD STE 150
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22202-5604
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3600 S GLEBE RD STE 150
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22202-5604
Country	:	US
Telephone Number	:	703-924-2100
Fax Number	:

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

Provider Enumeration Date	:	01/08/2025
Last Update Date	:	02/02/2026

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Directions to “ LARISSA BRAGA BEASON ” Practice Location

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