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NPI Code Detail

MEDICARE: JACOB FARR

MEDICARE: JACOB FARR
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
1208D00000XGeneral Practice Physician0101288407VA

General Provider Information

NPI Number : 1285490946
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACOB FARR
Provider Business Mailing Address
First Line : 9040 JACKSON AVE
Second Line :
City : TACOMA
State : WA
Zip : 98431-0001
Country : US
Telephone Number : 253-968-1440
Fax Number :
Provider Business Practice Location Address
First Line : 9040 JACKSON AVE
Second Line :
City : TACOMA
State : WA
Zip : 98431-0001
Country : US
Telephone Number : 253-968-1440
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2024
Last Update Date : 04/08/2026

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Directions to “ JACOB FARR ” Practice Location

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