Bradley Larsen, DDS is a medicare enrolled "Dentist - General Practice" provider in Morton, Washington. His current practice location is
148 Division Ave, Morton, Washington. You can reach out to his office (for appointments etc.) via phone at
(360) 496-5101.
Bradley Larsen is licensed to practice in Washington (license number DE00005129) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1760404164.
Healthcare Provider's Profile
Full Name | Bradley Larsen |
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Gender | Male |
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Speciality | Dentist - General Practice |
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Location | 148 Division Ave, Morton, Washington |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1760404164
- Provider Enumeration Date: 07/24/2006
- Last Update Date: 02/07/2023
Medicare PECOS Information:
- PECOS PAC ID: 5193036093
- Enrollment ID: I20150618002187
Medical Identifiers
Medical identifiers for Bradley Larsen such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1760404164 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223G0001X | Dentist - General Practice | DE00005129 (Washington) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Bradley Larsen is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Bradley Larsen, DDS 2114 Main St Ste 100-140, Vancouver, WA 98660-2674 Ph: () - | Bradley Larsen, DDS 148 Division Ave, Morton, WA 98356-9300 Ph: (360) 496-5101 |
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