DR. MARK W LARSON (NPI# 1194784090) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194784090 |
| Entity Type | Individual |
| Full Name | DR. MARK W LARSON |
| Credential | M.D. |
| Practice Address |
716 E Manitoba Ave Ellensburg WA 98926-3842 |
| Practice Telephone | 5099253151 |
| Mailing Telephone | 5099253151 |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2010-03-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 2520900035733 | WA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 8219073 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538524905 | Mark Larson | Dentist | 5441 Saint Marys Cir, Westminster, CA 92683-3416 | 2015-12-29 |
| 1265876056 | Mark Wayne Larson | Massage Therapist | 10093 Sunny Ln, Ooltewah, TN 37363-8487 | 2013-04-23 |
| 1821310285 | Mark Larson | Pharmacist | 10 Westwood Cir, Minnetonka, MN 55305-1588 | 2010-02-25 |
| 1770644767 | Mark Duane Larson | Plastic Surgery | 755 N 11th St Ste P1000, Beaumont, TX 77702-1528 | 2006-12-13 |
| 1376553503 | Mark Douglas Larson | Counselor | 605 East Boulevard, Methodist Counseling & Consultation Services, Charlotte, NC 28203-5111 | 2006-08-09 |
| 1124088208 | Mark R. Larson | Psychologist | 130 Allens Creek Rd, Rochester, NY 14618-3305 | 2006-03-24 |
| 1669452678 | Mark P Larson | Dentist | 278 Star Hill Dr, Cape Carteret, NC 28584-8933 | 2006-01-18 |
| 1831651868 | Mark Daniel Larson | Student in an Organized Health Care Education/Training Program | 5000 W Chambers St, Milwaukee, WI 53210-1650 | 2019-03-31 |
| 1942789318 | Mark Larson | Nurse Practitioner | 2373 Augusta Hwy, Lexington, SC 29072-2213 | 2018-08-07 |
| 1497973416 | Mark Thomas Larson | Emergency Medicine | 914 S Scheuber Rd, Centralia, WA 98531-9027 | 2007-04-23 |
| Street Address |
716 E MANITOBA AVE |
| City | ELLENSBURG |
| State | WA |
| Zip Code | 98926-3842 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831194265 | The Valley Clinic LLP | Specialist | 716 E Manitoba Ave, Ellensburg, WA 98926-3842 | 2005-06-13 |
| 1356808596 | Carissa A Dahl | Family Medicine | 716 E Manitoba Ave, Ellensburg, WA 98926-3842 | 2019-02-25 |
| 1720568033 | William Phillips | Physician Assistant | 716 E Manitoba Ave, Ellensburg, WA 98926-3842 | 2018-08-16 |
| 1538649843 | Anna Frances Parr | Physician Assistant | 716 E Manitoba Ave, Ellensburg, WA 98926-3842 | 2018-08-16 |
| 1699267963 | Desirae Bloomquist | Registered Nurse | 716 E Manitoba Ave, Ellensburg, WA 98926-3842 | 2018-06-03 |
| 1124538905 | Brett J White | Physician Assistant | 716 E Manitoba Ave, Ellensburg, WA 98926-3842 | 2017-10-05 |
| 1891199212 | Patricia Robertson | Registered Nurse | 716 E Manitoba Ave, Ellensburg, WA 98926-3842 | 2014-10-14 |
| 1114259751 | Sonja H Huebner | Nurse Practitioner | 716 E Manitoba Ave, Ellensburg, WA 98926 | 2010-02-08 |
| 1922336932 | Lori Ann Drews | Nurse Practitioner | 716 E Manitoba Ave, Ellensburg, WA 98926-3842 | 2009-12-02 |
| 1457581936 | Kittitas County Public Hospital | Registered Nurse | 716 E Manitoba Ave, Ellensburg, WA 98926-3842 | 2009-07-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407286214 | Sarah Rae | Occupational Therapist | 1050 E Mountian View Ave, Ellensburg, WA 98926 | 2013-11-14 |
| 1366885691 | Leslie-ann Fox I | Pharmacist | 521 East Mountain View Ave, Ellensburg, WA 98926 | 2013-04-17 |
| 1972877330 | Terri Lee Hughes | Pharmacist | 608 E Mountainview, Ellensburg, WA 98926 | 2012-03-02 |
| 1366716789 | Eiko Hama | Pharmacist | 608 E Mountain View, Ellensburg, WA 98926 | 2012-03-02 |
| 1689971228 | Carolyn Jeannette Brunk | Massage Therapist | 814 East 5th Avenue, Ellensburg, WA 98926 | 2011-02-17 |
| 1275862468 | Creekside Dental Ellensburg Pllc | Dentist | 2601 Triple L Loop, Ellensburg, WA 98926 | 2009-12-17 |
| 1659605038 | Michael Alan Patin | Pharmacist | 700 S. Main St., Ellensburg, WA 98926 | 2009-10-01 |
| 1538391040 | Brenden J Davis | Dentist | 1206 N Dolarway Rd Ste 208, Ellensburg, WA 98926 | 2009-08-17 |
| 1821206186 | Peggy Elaine Erickson | Massage Therapist | 314 E 4th, Ellensburg, WA 98926 | 2007-05-18 |
| 1295951259 | Kenneth Francis Kladnik | Specialist/Technologist | 1711 E. Canterbury, Ellesnburg, WA 98926 | 2007-04-18 |
| Find all providers in zip 98926 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790910057 | Kittitas County Public Hospital Dist 1 | Specialist | 611 S Chestnut St Ste A, Ellensburg, WA 98926-4815 | 2009-05-15 |
| 1851559652 | Randal D. Gillen | Specialist | 507 N Pine St, Suite E, Ellensburg, WA 98926-5024 | 2008-05-28 |
| 1619151164 | Daniel L Hiersche, Pllc | Specialist | 700 E Manitoba Ave Ste 106, Ellensburg, WA 98926-3885 | 2007-12-19 |
| 1912187378 | Carla Johnson | Specialist | 1206 N Dolarway Rd, Suite # 211, Ellensburg, WA 98926-8392 | 2007-11-13 |
| 1437344504 | Marlene J Travis | Specialist | 305 N Maple St, Ellensburg, WA 98926-3574 | 2007-09-11 |
| 1639363179 | Paula Brinkerhoff | Specialist | 1501 Killmore Rd, Ellensburg, WA 98926-7844 | 2007-08-28 |
| 1003016825 | Kittitas County Public Hospital Dist 1 | Specialist | 611 S Chestnut St Ste D, Ellensburg, WA 98926-4815 | 2007-07-19 |
| 1164640256 | Mary Call | Specialist | 3420 Reecer Creek Rd, Ellensburg, WA 98926-9430 | 2007-04-23 |
| 1942350327 | Tina Tarbert | Specialist | 1011 N Alder St Ste 4, Ellensburg, WA 98926-2699 | 2007-01-10 |
| 1841277845 | Kenneth A Harris | Specialist | 611 S Chestnut Street, Suite A, Ellensburg, WA 98926 | 2005-12-30 |
| Find all providers in ELLENSBURG | ||||
| City | ELLENSBURG |
| Zip Code | 98926 |
Please comment or provide details below to improve the information on DR. MARK W LARSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.