Tanya Rene Larson, LMP

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA00020919 Issued in WA

Practice address

120 N. Oak St
Burlington, WA 98233

Phone

(425) 319-6809

Fax

(360) 755-1305

NPI assigned

Nov 21, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Tanya Rene Klein Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1195603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418688000000",
    "number": "1356522049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 N. OAK ST.",
            "city": "BURLINGTON",
            "state": "WA",
            "postal_code": "98233",
            "telephone_number": "425-319-6809",
            "fax_number": "360-755-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N. OAK ST",
            "city": "BURLINGTON",
            "state": "WA",
            "postal_code": "98233",
            "telephone_number": "425-319-6809",
            "fax_number": "360-755-1305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "TANYA",
        "middle_name": "RENE",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-21",
        "last_updated": "2014-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA00020919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TANYA",
            "last_name": "KLEIN",
            "middle_name": "RENE",
            "credential": "LMP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Justin Kooistra
• Kotlerman Family Health LLC
• Zachary Aaron Kotlerman, DC
• Melisa A Kraayvanger, DC
• Rosemarie Labelle, LMP
• Michael Anderson Layton, DC, PA
• Pawadee Lohavanichbutr, MD
• Shala Look, CCC-SLP
• Gabriela Lopez
• Rachel D Luke, MA, LMHCA

• Specialist in Burlington, WA
• Providers in Burlington, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.