Individual
HOLLY ROSS FARNAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
410 W POPLAR ST, WALLA WALLA, WA 99362
(509) 897-2100
(509) 897-5752
Mailing address
410 W POPLAR ST, WALLA WALLA, WA 99362
(509) 897-3320
(509) 897-5752
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00007602
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT00007602
WA STATE DEPARTMENT OF HEALTH
WA
Enumeration date
01/20/2017
Last updated
01/20/2017
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