Active NPI
Donna M Larsen, PHD
- Psychologist
- Bellevue, WA
National Provider Identifier
1750572624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 10420
- Practice address
- 12301 NE 10TH PL
#301
Bellevue, WA 98005 - Phone
- (425) 643-4712
- Fax
- (425) 643-8215
- NPI assigned
- Aug 6, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 10420 | WA | Primary |
Addresses
Primary practice location
12301 NE 10TH PL
#301
Bellevue, WA 98005
Mailing address
12301 NE 10TH PL
#301
Bellevue, WA 98005
Phone (425) 643-4712
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10420 | WA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186358400000",
"number": "1750572624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12301 NE 10TH PL",
"address_2": "#301",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "98005",
"telephone_number": "425-643-4712",
"fax_number": "425-643-8215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12301 NE 10TH PL",
"address_2": "#301",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "98005",
"telephone_number": "425-643-4712",
"fax_number": "425-643-8215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSEN",
"first_name": "DONNA",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-08-06",
"last_updated": "2007-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WA",
"license": "10420",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.