| Doctor Name: | KATELIN LARSON |
| NPI Number: | 1013388016 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CPNP |
| License Number: | AP60605385 |
| Business Practice Address: | 3434 12th Ave Ne Olympia, WA - 985065175 |
| Business Phone Number: | 5095920553 |
| Business Fax Number: | |
| Mailing Address: | Po Box 7603, OLYMPIA |
| State: | WA |
| Postal Code: | 985077603 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 10/15/2015 |
| NPI Last Update Date: | 10/15/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | AP60605385 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |