Provider Demographics
NPI:1033439112
Name:FARRAR, MICHEAL C (R PH)
Entity Type:Individual
Prefix:MR
First Name:MICHEAL
Middle Name:C
Last Name:FARRAR
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2860 NW BUCKLIN HILL RD
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8513
Mailing Address - Country:US
Mailing Address - Phone:360-692-3410
Mailing Address - Fax:360-692-5387
Practice Address - Street 1:2860 NW BUCKLIN HILL RD
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8513
Practice Address - Country:US
Practice Address - Phone:360-692-3410
Practice Address - Fax:360-692-5387
Is Sole Proprietor?:No
Enumeration Date:2010-06-10
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00016749183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist