| Doctor Name: | JAMIE LYNN LARSEN |
| NPI Number: | 1720394174 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPT |
| License Number: | 00010795 |
| Business Practice Address: | 1010 Bryden Ave Suite A Lewiston, ID - 835012713 |
| Business Phone Number: | 2087460455 |
| Business Fax Number: | 2087460688 |
| Mailing Address: | 1019 3rd St, LEWISTON |
| State: | ID |
| Postal Code: | 835012713 |
| Phone Number: | 2087460455 |
| Fax Number: | 2087460688 |
| NPI Enumeration Date: | 08/24/2010 |
| NPI Last Update Date: | 10/20/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 00010795 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |