Provider Demographics
NPI:1932331683
Name:FARRELL, STEPHANIE K (ND)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:K
Last Name:FARRELL
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 1:3225 SW 87TH AVE # 25663
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-3407
Mailing Address - Country:US
Mailing Address - Phone:503-719-7430
Mailing Address - Fax:503-336-0129
Practice Address - Street 1:10700 SW BEAVERTON HILLSDALE HWY STE 560
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-4791
Practice Address - Country:US
Practice Address - Phone:503-719-7430
Practice Address - Fax:503-336-0129
Is Sole Proprietor?:No
Enumeration Date:2009-08-13
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1604175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath