Individual
LARRY D FARNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4007 BRIDGEPORT WAY W, SUITE C, UNIVERSITY PLACE, WA 98466-4330
(253) 565-7529
(253) 399-2508
Mailing address
4007 BRIDGEPORT WAY W, SUITE C, UNIVERSITY PLACE, WA 98466-4330
(253) 565-7529
(253) 399-2508
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT00000922
WA
Other
Enumeration date
12/05/2005
Last updated
10/10/2012
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