Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 125051468 | IL |
NPI | 1013159425 |
---|---|
Provider Name | Megan Augusta Farnsworth |
First Address | Mukilteo, WA 98275-3629 |
Second Address | Mukilteo, WA 98275-3629 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2009 |
Last Update Date | 01/03/2021 |