Jeffrey A Larson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1377TX Issued in WA

Practice address

720 Birchwood Ave
Bellingham, WA 98225-1714

Phone

(360) 733-1720

Fax

(360) 733-0109

NPI assigned

Mar 1, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400025600000",
    "number": "1740318518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5566",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982275566",
            "telephone_number": "360-733-1720",
            "fax_number": "360-733-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 BIRCHWOOD AVE",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251714",
            "telephone_number": "360-733-1720",
            "fax_number": "360-733-0109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "JEFFREY",
        "middle_name": "A",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2014-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "1377TX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DH0545",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2027829",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Kristine Larsen, O.D.
• Kylie June Larsen, RN
• Renee Larsen
• Shannon Marie Larsen
• Anne Pfeffer Larson, M.ED. LMHC
• Jeremy Sloan Larson
• Jessica Anne Larson, LMP
• Joanna Christine Larson, MSW
• Nathan L Larson, DPM
• Mahnaz Lary, MD

• Optometrist in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2014; 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.