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General NPI Number Information
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NPI Number | 1952728891
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Entity Type | Individual
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Provider Name | FERGUSON ADESOYE CEO
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Gender | Male
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Dates
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Enumeration Date | 03/27/2014
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Last Update Date | 03/27/2014
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Provider Practice Location Address
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Address Line | 15210 32ND AVE S
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City | SEATAC
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State | WA
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Zip | 98188-2103
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Country | US
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Telephone | 800-731-3920
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Fax | 800-731-3920
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Provider Business Mailing Address
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Address Line | 15210 32ND AVE S
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City | SEATAC
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State | WA
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Zip | 98188-2103
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Country | US
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Telephone | 800-731-3920
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Fax | 800-731-3920
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | IHS.FS.60438565
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License Number State | WA
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