Provider Demographics
NPI:1770953085
Name:FARRIS, JOSEPH MATTHEW (DC)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MATTHEW
Last Name:FARRIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2552 NE PURCELL BLVD
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-6094
Mailing Address - Country:US
Mailing Address - Phone:425-492-6916
Mailing Address - Fax:
Practice Address - Street 1:296 SW COLUMBIA ST STE D1
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-1020
Practice Address - Country:US
Practice Address - Phone:541-600-2558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-29
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60610067111N00000X
390200000X
OR6307111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program