Provider Demographics
NPI:1376812156
Name:FARRIS, LINDA MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:MARIE
Last Name:FARRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 SW 4TH AVE
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97201-4953
Mailing Address - Country:US
Mailing Address - Phone:503-279-5200
Mailing Address - Fax:503-279-5297
Practice Address - Street 1:2020 SW 4TH AVE
Practice Address - Street 2:SUITE 1000
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97201-4953
Practice Address - Country:US
Practice Address - Phone:503-279-5200
Practice Address - Fax:503-279-5297
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-22
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR12079207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine