Individual provider Active NPI

Kassaundra Eva Larson, PTA

  • Physical Therapy Assistant
  • Richland, WA
National Provider Identifier
1477353316
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
P161267978 Issued in WA
Practice address
299 Bradley Blvd Ste 101
Richland, WA 99352-4691
Phone
(509) 713-7555
Fax
(509) 783-6151
NPI assigned
Mar 18, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X P161267978 WA Primary

Addresses

Primary practice location

299 Bradley Blvd Ste 101
Richland, WA 99352-4691

Mailing address

2839 W Kennewick Ave # 550
Kennewick, WA 99336-2927
Phone (509) 783-8977

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

State licenses

LicenseStateTypeSpecialty
P161267978WAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Superior Health Care PLLC CurrentSince Mar 24, 2025 Accepting new patients

Locations

2839 W Kennewick Ave
Kennewick, WA 99336
Phone (509) 783-8977

299 Bradley Blvd
Ste 101
Richland, WA 99352
Phone (509) 713-7555

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1742256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1477353316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2839 W KENNEWICK AVE # 550",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993362927",
            "telephone_number": "509-783-8977",
            "fax_number": "509-783-6151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299 BRADLEY BLVD STE 101",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524691",
            "telephone_number": "509-713-7555",
            "fax_number": "509-783-6151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "KASSAUNDRA",
        "middle_name": "EVA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-18",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P161267978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; 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.