Provider Demographics
NPI:1114038478
Name:FARLEY, NORMAN D (PHD)
Entity Type:Individual
Prefix:
First Name:NORMAN
Middle Name:D
Last Name:FARLEY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:VA PUGET SOUND HCS
Mailing Address - Street 2:AMERICAN LAKE DIVISION
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98493-0001
Mailing Address - Country:US
Mailing Address - Phone:800-329-8387
Mailing Address - Fax:253-589-4167
Practice Address - Street 1:VA PUGET SOUND HCS
Practice Address - Street 2:AMERICAN LAKE DIVISION
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98493-0001
Practice Address - Country:US
Practice Address - Phone:800-329-8387
Practice Address - Fax:253-589-4167
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00001364103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical