Active NPI
Tess Marie Larson, PHARMD
- Pharmacist
- Stanwood, WA
National Provider Identifier
1104429414
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH61068926
- Practice address
- 7205 265TH St NW
Stanwood, WA 98292-6221 - Phone
- (360) 629-1500
- Fax
- (360) 629-1513
- NPI assigned
- Nov 18, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH61068926 | WA | Primary |
Addresses
Primary practice location
7205 265TH St NW
Stanwood, WA 98292-6221
Mailing address
PO Box 5127
Everett, WA 98206-5127
Phone (360) 629-1500
Other practice location 1
601 McPhee Rd SW Bldg 2
Olympia, WA 98502-5080
Phone (360) 956-2543
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH61068926 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617926400000",
"number": "1104429414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5127",
"city": "EVERETT",
"state": "WA",
"postal_code": "982065127",
"telephone_number": "360-629-1500",
"fax_number": "360-629-1513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7205 265TH ST NW",
"city": "STANWOOD",
"state": "WA",
"postal_code": "982926221",
"telephone_number": "360-629-1500",
"fax_number": "360-629-1513"
}
],
"practiceLocations": [
{
"address_1": "601 McPhee Rd SW Bldg 2",
"address_purpose": "LOCATION",
"city": "Olympia",
"state": "WA",
"postal_code": "985025080",
"country_code": "US",
"telephone_number": "360-956-2543",
"fax_number": "360-956-2545",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LARSON",
"first_name": "TESS",
"middle_name": "MARIE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-18",
"last_updated": "2021-04-09",
"certification_date": "2021-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH61068926",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stanwood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.