Provider Demographics
NPI:1639393010
Name:FARR, DEBI (RPH,BS PHARM MTMCP)
Entity Type:Individual
Prefix:
First Name:DEBI
Middle Name:
Last Name:FARR
Suffix:
Gender:F
Credentials:RPH,BS PHARM MTMCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21925 SW 109TH TER
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-6040
Mailing Address - Country:US
Mailing Address - Phone:503-708-6446
Mailing Address - Fax:
Practice Address - Street 1:21925 SW 109TH TER
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-6040
Practice Address - Country:US
Practice Address - Phone:503-708-6446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00020916183500000X
OR81591835G0303X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric