Provider Demographics
NPI:1700155900
Name:FARIN, ANJA D (CPM, LDM)
Entity Type:Individual
Prefix:
First Name:ANJA
Middle Name:D
Last Name:FARIN
Suffix:
Gender:F
Credentials:CPM, LDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 MONMOUTH AVE S
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH
Mailing Address - State:OR
Mailing Address - Zip Code:97361-2110
Mailing Address - Country:US
Mailing Address - Phone:503-436-7414
Mailing Address - Fax:503-506-6902
Practice Address - Street 1:180 RAMSGATE SQ S
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-5864
Practice Address - Country:US
Practice Address - Phone:503-436-7414
Practice Address - Fax:503-506-6902
Is Sole Proprietor?:No
Enumeration Date:2011-12-19
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDEM-LD-10230407176B00000X
WI47-49176B00000X
WI47-049176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife