MEDICARE: TRAVIS FRIEND

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	247200000X	Other Technician

General Provider Information

NPI Number	:	1831053644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRAVIS FRIEND

Provider Business Mailing Address
First Line	:	907 HARNEY ST STE 100
Second Line	:
City	:	VANCOUVER
State	:	WA
Zip	:	98660-3038
Country	:	US
Telephone Number	:	360-217-4205
Fax Number	:

Provider Business Practice Location Address
First Line	:	5920 100TH ST SW STE 26
Second Line	:
City	:	LAKEWOOD
State	:	WA
Zip	:	98499-2751
Country	:	US
Telephone Number	:	253-317-1792
Fax Number	:

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

Provider Enumeration Date	:	12/15/2025
Last Update Date	:	12/15/2025

Similar Medicare Providers

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Practice Location Address:

5920 100TH ST SW STE 26
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1427054469 — DR. DAVID R BENSON MD
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1700830213 — CORNERSTONE FAMILY PHYSICIANS
Practice Location Address:

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1518913680 — DR. JAMES ALLAN WILSON MD
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1750329777 — STEPHANI J. AMSTADTER M.D.
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Directions to “ TRAVIS FRIEND ” Practice Location

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