Individual
CAROLYN FRANCES FARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA60320459
WA
363AS0400X
Surgical Physician Assistant
Primary
PA169154
OR
Other
Enumeration date
11/07/2011
Last updated
12/28/2015
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