MEDICARE: DIRK FARRELL D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH00003200	WA

General Provider Information

NPI Number	:	1184846206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIRK FARRELL D.C.

Provider Business Mailing Address
First Line	:	6217 ROOSEVELT WAY NE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98115
Country	:	US
Telephone Number	:	206-548-9450
Fax Number	:

Provider Business Practice Location Address
First Line	:	6217 ROOSEVELT WAY NE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98115
Country	:	US
Telephone Number	:	206-548-9450
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	10/15/2012

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