Individual
THOMAS R FAHRBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10123 SE MARKET ST, PORTLAND, OR 97216-2532
(503) 261-6985
(503) 261-6790
Mailing address
PO BOX 92900, PORTLAND, OR 97292-0900
(503) 261-6985
(503) 261-6790
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD18697
OR
208M00000X
Hospitalist Physician
Primary
MD18697
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060553
—
OR
05
—
8155145
—
WA
Enumeration date
04/20/2006
Last updated
12/07/2017
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