Individual
CLYDE ALAN FARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19250 SW 65TH AVE, SUITE 200, TUALATIN, OR 97062
(503) 692-6990
(503) 691-6387
Mailing address
19250 SW 65TH AVE, SUITE 200, TUALATIN, OR 97062
(503) 692-6990
(503) 691-6387
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD11437
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
066514
—
OR
Enumeration date
08/29/2006
Last updated
02/21/2008
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