Individual
JACOB FARMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
811 NE 112TH AVE, SUITE 100, VANCOUVER, WA 98684-5115
(360) 604-7151
Mailing address
14305 NE 94TH ST, VANCOUVER, WA 98682-3083
(360) 909-2700
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE60475801
WA
Other
Enumeration date
06/26/2014
Last updated
06/26/2014
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