HEATHER D LARSON (PA-C) – Physician Assistant, NPI 1023465564

HEATHER D LARSON (PA-C) is a healthcare provider. based in Seattle, Washington. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. The NPI Number for HEATHER D LARSON (PA-C) is 1023465564

Main info

Female
9 Years Of Experience
Accepts Medicare Assignment
Name
HEATHER D LARSON (PA-C)
NPI
1023465564
Phone
(206) 616-6400
Address
4311 11th Ave NE
Enumeration Date
13 May 2016
Last Update Date
27 January 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2017 (9 years ago)
PAC ID
6507125317
Group Practice PAC ID
0345135414
Professional Enrollment ID
I20180123002593
Address ID
UT844011511Og2240XAVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience35
Completeness75
Years active:10State licenses:0Digital endpointsOther names

4,282 PHYSICIAN ASSISTANT in WA

Provider Addresses for HEATHER D LARSON (PA-C)

  • 4311 11th Ave NE

    Suite 200

    Seattle, WA 981056366

    Phone: (206) 616-6400

    Type: Location

  • 862, East 670 North, Ogden, Weber County, Utah, 84404, United States

    OGDEN, UT 844043888

    Phone: (801) 336-0629

    Type: Mailing

  • 2240, Adams Avenue, 25th Street, Ogden, Weber County, Utah, 84401, United States

    OGDEN, UT 844011511

    Phone: (801) 393-5355

    Type: Location

  • 2240 ADAMS AVE

    OGDEN, UT 844011511

    Phone: (801) 393-5355

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-01-23

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180123002593IPhysician AssistantUTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98105)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0345135414View full group profile
NameSpecialtyState
Physician AssistantUT
Clinical Social WorkerUT
Nurse PractitionerUT
Physician AssistantUT
-UT
Family PracticeUT
Physician AssistantUT
Family PracticeUT
Physician AssistantUT
P S Y C H I A T R YUT

Reviews

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Frequently asked questions

Where can patients find HEATHER D LARSON (PA-C)'s NPI?
You can confirm HEATHER D LARSON (PA-C) with NPI 1023465564; it appears in the national provider directory.
Is HEATHER D LARSON (PA-C)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does HEATHER D LARSON (PA-C) list a primary specialty?
If you are matching referrals, note Physician Assistant for HEATHER D LARSON (PA-C). Clinical services aligned with this taxonomy classification.
Does HEATHER D LARSON (PA-C) practice in Washington?
You will see Seattle, Washington on file for HEATHER D LARSON (PA-C) alongside any extra practice locations.
What if Seattle, Washington seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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