Individual
GRANTHEM T FARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1111 NE 99TH AVE STE 200, PORTLAND, OR 97220
(503) 963-3030
(503) 963-3140
Mailing address
541 NE 20TH AVE STE 225, PORTLAND, OR 97232-2895
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
DO185757
OR
207RP1001X
Pulmonary Disease Physician
Primary
DO185757
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2098782
—
WA
05
—
500743783
—
OR
Enumeration date
04/28/2011
Last updated
11/22/2024
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