Provider Demographics
NPI:1043534878
Name:LARSON, MATTHEW GOLDEN (DC)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:GOLDEN
Last Name:LARSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:36015 SE 96TH WAY
Mailing Address - Street 2:
Mailing Address - City:SNOQUALMIE
Mailing Address - State:WA
Mailing Address - Zip Code:98065-9218
Mailing Address - Country:US
Mailing Address - Phone:425-898-3055
Mailing Address - Fax:425-898-8005
Practice Address - Street 1:23515 NE NOVELTY HILL RD STE B225
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98053-2073
Practice Address - Country:US
Practice Address - Phone:425-898-8000
Practice Address - Fax:425-898-8005
Is Sole Proprietor?:No
Enumeration Date:2010-03-23
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00033791111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor