Individual
LISA FARWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 NE BURNSIDE AVE, BEND, OR 97701-5122
(541) 797-0098
Mailing address
18600 SE MCLOUGHLIN BLVD, MILWAUKIE, OR 97267-6723
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-23-3229
OR
Other
Enumeration date
12/20/2023
Last updated
12/20/2023
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