| Larsen Gastroenterology, Pllc | |
|
625 6th St Clarkston WA 99403-2010 | |
| (509) 758-2200 | |
| Not Available |
| Full Name | Larsen Gastroenterology, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 625 6th St, Clarkston, Washington |
| Authorized Official Name and Position | Michelle Marie Hastings (OFFICE MANAGER) |
| Authorized Official Contact | 5097582200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Larsen Gastroenterology, Pllc 625 6th St Clarkston WA 99403-2010 Ph: (509) 758-2200 | Larsen Gastroenterology, Pllc 625 6th St Clarkston WA 99403-2010 Ph: (509) 758-2200 |
| NPI Number | 1174940282 |
|---|---|
| Provider Enumeration Date | 03/26/2014 |
| Last Update Date | 01/09/2024 |
| Medicare PECOS PAC ID | 1759505621 |
|---|---|
| Medicare Enrollment ID | O20140616001328 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174940282 | NPI | - | NPPES |
| 2039081 | Medicaid | WA | |
| 0027334 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | MD 00029346 (Washington) | Primary |
| Provider Name | Murray I Larsen |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1568451102 PECOS PAC ID: 4486629573 Enrollment ID: I20041013000416 |
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