Healthcare Provider Details
I. General information
NPI: 1700044054
Provider Name (Legal Business Name): FERNANDA MUSA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/22/2008
Last Update Date: 12/06/2025
Certification Date: 12/06/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1101 MADISON ST STE 1500
SEATTLE WA
98104-3551
US
IV. Provider business mailing address
PO BOX 25608
SALT LAKE CITY UT
84125-0608
US
V. Phone/Fax
- Phone: 206-991-2000
- Fax: 206-991-2005
- Phone: 206-320-4476
- Fax: 206-568-7043
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 260723-1 |
| License Number State | NY |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VX0201X |
| Taxonomy | Gynecologic Oncology Physician |
| License Number | MD60789985 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: