Individual ProviderKellie LarsonNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1100 9th Ave, Seattle, WA 98101-2756(206) 223-6980PECOS EnrollmentBased on the most recent information from CMS, provider Kellie Larson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1144889312Provider TypeIndividualFull NameLarson, KellieGenderFemaleSole ProprietorNoEnumeration Date6/11/2019Last Updated2/25/2026Contact InformationPractice LocationPractice Address1100 9th Ave, Seattle, WA 98101-2756Phone(206) 223-6980FaxUnlisted FaxMailing LocationMailing Address1100 9th Ave, Seattle, WA 98101-2756Phone(206) 223-6980FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode367500000XPrimaryDescriptionNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAP61186904Washington