Provider Demographics
NPI:1447828942
Name:FARRAN, AIMAN
Entity type:Individual
Prefix:
First Name:AIMAN
Middle Name:
Last Name:FARRAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1071 PROSSER AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:PROSSER
Mailing Address - State:WA
Mailing Address - Zip Code:99350-1580
Mailing Address - Country:US
Mailing Address - Phone:360-836-4277
Mailing Address - Fax:
Practice Address - Street 1:1071 PROSSER AVE APT 3
Practice Address - Street 2:
Practice Address - City:PROSSER
Practice Address - State:WA
Practice Address - Zip Code:99350-1580
Practice Address - Country:US
Practice Address - Phone:360-836-4277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-12
Last Update Date:2021-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA606692311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical