Provider Demographics
NPI:1578939203
Name:FARR, AUTUMN WILLOW (ND)
Entity Type:Individual
Prefix:DR
First Name:AUTUMN
Middle Name:WILLOW
Last Name:FARR
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 FIELDSTON RD APT 1
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-7863
Mailing Address - Country:US
Mailing Address - Phone:360-510-7141
Mailing Address - Fax:
Practice Address - Street 1:1420 KING ST STE D
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-6264
Practice Address - Country:US
Practice Address - Phone:360-389-2633
Practice Address - Fax:866-509-6323
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-17
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60580076175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath