| Doctor Name: | DR. PAUL RICHARD LARSEN |
| NPI Number: | 1720189749 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | MD00037362 |
| Business Practice Address: | 100 W South Ave Chewelah, WA - 99019 |
| Business Phone Number: | 5099358111 |
| Business Fax Number: | 5099358402 |
| Mailing Address: | Po Box 421, LIBERTY LAKE |
| State: | WA |
| Postal Code: | 990190421 |
| Phone Number: | 8667472455 |
| Fax Number: | 5099449644 |
| NPI Enumeration Date: | 09/25/2006 |
| NPI Last Update Date: | 10/29/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207VX0000X |
| License Number: | MD00037362 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | Obstetrics |
| Taxonomy Definition: | |