Individual
JOANNA RAE FARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1650 NE 32ND AVE APT 425, PORTLAND, OR 97232-3455
(345) 595-5456
Mailing address
1650 NE 32ND AVE APT 425, PORTLAND, OR 97232-3455
(345) 595-5456
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
201909575NP-PP
OR
363LG0600X
Gerontology Nurse Practitioner
201909575NP-PP
OR
Other
Enumeration date
02/18/2020
Last updated
02/18/2020
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