Individual
KATHERINE FARDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
840 SW 4TH AVE STE 103, ONTARIO, OR 97914-2638
(541) 881-7330
Mailing address
PO BOX 145, NEW PLYMOUTH, ID 83655-0145
(208) 880-7654
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3580
OR
225100000X
Physical Therapist
PT-1067
ID
Other
Enumeration date
08/19/2020
Last updated
08/19/2020
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