Active NPI
Katharine Larson, PT, BCHN
- Nutritionist
- Snohomish, WA
National Provider Identifier
1609067818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- License
- NU61214108
- Practice address
- 12301 86TH PL SE
Snohomish, WA 98290-6260 - Phone
- (425) 653-4308
- NPI assigned
- Aug 5, 2007
- Last updated
- May 9, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7018120 | Medicaid | WA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| NU61214108 | WA | MD | Nutritionist |
| PT00010647 | WA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children's Therapy of Woodinville | Nutritionist | Past | 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.
-
dba CTW
- Pediatric Occupational Therapist
- Bothell, WA
- NPI 1558440198
Nutritionist
-
- Specialist
- Bellevue, WA
- NPI 1275670572
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.