IndividualActive
Beau Larson
NPI 1932087665 · Physician Assistant · Missoula, MT
Provider details
- NPI number
- 1932087665
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- MED-PAC-LIC-164422 (MT)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
500 W Broadway St Ste 320
Missoula, MT 59802-4003
Phone: (406) 329-5615
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 31001
Pasadena, CA 91110-4110
Registry dates
- Enumerated
- 2025-08-21
- Last updated
- 2025-12-09
- Certified
- 2025-12-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.