Farina, Autumn

Farina, Autumn is an individual health care provider with primary practice located at 6060 Portal Way , Ferndale WA 98248-7833. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Farina, Autumn can be contacted via phone (360) 676-6177.

Contact Information

Primary practice address
6060 Portal Way Ferndale WA 98248-7833
Phone: (360) 676-6177
Fax: (360) 671-3574
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X LH60774654 Washington
Behavioral Health & Social Service Providers / Mental Health 101YM0800X LH60774654 Washington

Profile Details

NPI number 1417334822
LBN Legal business name Farina, Autumn
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 5th, 2015
Last updated Jul 17th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417334822 NPPES
Washington MEDICAID 2083481

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