Provider Demographics
NPI:1508035510
Name:FARLAND, JENNIFER LYNN (BS)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LYNN
Last Name:FARLAND
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1339 COMMERCE AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-3738
Mailing Address - Country:US
Mailing Address - Phone:360-423-3997
Mailing Address - Fax:360-423-3976
Practice Address - Street 1:1339 COMMERCE AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-3738
Practice Address - Country:US
Practice Address - Phone:360-423-3997
Practice Address - Fax:360-423-3976
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-23
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service