Individual provider Active NPI

Cynthia M Larson, LMP

  • Specialist
  • Kirkland, WA
National Provider Identifier
1700933488
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA00007116 Issued in WA
Practice address
11821 NE 128TH St Ste B
Kirkland, WA 98034-7210
Phone
(425) 814-2800
Fax
(425) 823-0882
NPI assigned
Jan 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA00007116 WA Primary

Addresses

Primary practice location

11821 NE 128TH St Ste B
Kirkland, WA 98034-7210

Mailing address

13044 111TH Ave NE
Kirkland, WA 98034-6306
Phone (206) 799-2562

Other identifiers 3

IdentifierTypeStateIssuer
REGENCEOtherWA7695LA
0182278OtherWAWA DEPT OF L&I
REGENCEOtherWALA6077

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
MA00007116WAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Lew C Estabrook DC PastSince Aug 1, 1999 Accepting new patients

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700933488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13044 111TH AVE NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980346306",
            "telephone_number": "206-799-2562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11821 NE 128TH ST STE B",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980347210",
            "telephone_number": "425-814-2800",
            "fax_number": "425-823-0882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "CYNTHIA",
        "middle_name": "M",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA00007116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "7695LA",
            "identifier": "REGENCE",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA DEPT OF L&I",
            "identifier": "0182278",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LA6077",
            "identifier": "REGENCE",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.