Provider Demographics
NPI:1306913678
Name:FARRELL JAMES DC
Entity type:Organization
Organization Name:FARRELL JAMES DC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FARRELL
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-613-0123
Mailing Address - Street 1:3100 NW BUCKLIN HILL RD STE 122
Mailing Address - Street 2:DR. FARRELL JAMES
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383
Mailing Address - Country:US
Mailing Address - Phone:360-613-0123
Mailing Address - Fax:360-613-5432
Practice Address - Street 1:3100 NW BUCKLIN HILL RD STE 122
Practice Address - Street 2:DR. FARRELL JAMES
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383
Practice Address - Country:US
Practice Address - Phone:360-613-0123
Practice Address - Fax:360-613-5432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034029111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
153584OtherWASHINGTON LABOR & INDUST
153584OtherWASHINGTON LABOR & INDUST
WAAB25697Medicare ID - Type Unspecified