Individual provider Active NPI

Kirsten Leigh Larson, PHARMD, MS

  • Pharmacist
  • Bothell, WA
National Provider Identifier
1366113821
Registry record updated Mar 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH61067497 Issued in WA
Practice address
1909 214TH St SE Ste 300
Bothell, WA 98021-4418
Phone
(425) 412-7200
NPI assigned
Sep 24, 2021
Last updated
Mar 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28214 MD
Pharmacist 183500000X PH61067497 WA Primary

Addresses

Primary practice location

1909 214TH St SE Ste 300
Bothell, WA 98021-4418

Mailing address

1909 214TH St SE Ste 300
Bothell, WA 98021-4418

Other practice location 1

10416 5th Ave NE
Seattle, WA 98125-7449
Phone (206) 517-6700

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
Master of Science, Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PH61067497WAMDPharmacist
28214MDMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1632441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1366113821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 214TH ST SE STE 300",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980214418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 214TH ST SE STE 300",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980214418",
            "telephone_number": "425-412-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10416 5th Ave NE",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981257449",
            "country_code": "US",
            "telephone_number": "206-517-6700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSON",
        "first_name": "KIRSTEN",
        "middle_name": "LEIGH",
        "credential": "PHARMD, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-24",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "28214",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH61067497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bothell, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; 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.