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General NPI Number Information
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NPI Number | 1710787569
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Entity Type | Individual
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Provider Name | RICHARD FARRELL LMT
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Gender | Male
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Dates
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Enumeration Date | 03/19/2025
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 14313 NE 20TH AVE STE A114
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City | VANCOUVER
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State | WA
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Zip | 98686-1485
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Country | US
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Telephone | 360-433-9480
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Fax | 877-905-0333
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Provider Business Mailing Address
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Address Line | 7110 NE 67TH ST
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City | VANCOUVER
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State | WA
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Zip | 98661-1126
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Country | US
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Telephone | 206-914-2989
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA61413369
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License Number State | WA
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