Individual provider Active NPI

Katharine Larson, PT, BCHN

  • Nutritionist
  • Snohomish, WA
National Provider Identifier
1609067818
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
NU61214108 Issued in WA
Practice address
12301 86TH PL SE
Snohomish, WA 98290-6260
Phone
(425) 653-4308
NPI assigned
Aug 5, 2007
Last updated
May 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X NU61214108 WA Primary
Specialist 174400000X PT00010647 WA

Addresses

Primary practice location

12301 86TH PL SE
Snohomish, WA 98290-6260

Mailing address

12301 86TH PL SE
Snohomish, WA 98290-6260
Phone (425) 653-4308

Other practice location 1

19021 120th Ave NE Ste 102
Bothell, WA 98011-9511
Phone (425) 486-7710

Other identifiers 1

IdentifierTypeStateIssuer
7018120MedicaidWA

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
NU61214108WAMDNutritionist
PT00010647WAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Therapy of Woodinville Nutritionist PastSince May 16, 2022 Accepting new patients
Kindering Center Specialist Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1609067818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12301 86TH PL SE",
            "city": "SNOHOMISH",
            "state": "WA",
            "postal_code": "982906260",
            "telephone_number": "425-653-4308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12301 86TH PL SE",
            "city": "SNOHOMISH",
            "state": "WA",
            "postal_code": "982906260",
            "telephone_number": "425-653-4308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19021 120th Ave NE Ste 102",
            "address_purpose": "LOCATION",
            "city": "Bothell",
            "state": "WA",
            "postal_code": "980119511",
            "country_code": "US",
            "telephone_number": "425-486-7710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSON",
        "first_name": "KATHARINE",
        "credential": "PT, BCHN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-05",
        "last_updated": "2024-05-09",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "WA",
            "license": "NU61214108",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "PT00010647",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7018120",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Snohomish, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; 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.