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General NPI Number Information
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NPI Number | 1689482135
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Entity Type | Individual
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Provider Name | KADI-ANN FERGUSON
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Gender | Female
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Dates
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Enumeration Date | 12/30/2024
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 1615 75TH ST SW STE 210
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City | EVERETT
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State | WA
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Zip | 98203-6293
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Country | US
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Telephone | 425-261-4800
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Fax |
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Provider Business Mailing Address
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Address Line | 20057 BALLINGER WAY NE APT B611
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City | SHORELINE
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State | WA
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Zip | 98155-5578
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Country | US
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Telephone | 253-393-3860
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 60771179
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License Number State | WA
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