Healthcare Provider Details
I. General information
NPI: 1871405894
Provider Name (Legal Business Name): SETH NATHANIEL FARISON
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
323 GARFIELD ST S
TACOMA WA
98444-5161
US
IV. Provider business mailing address
323 GARFIELD ST S
TACOMA WA
98444-5161
US
V. Phone/Fax
- Phone: 253-535-8633
- Fax:
- Phone: 253-535-8633
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: