MEDICARE: JENIFER LEHNE FERGUSON MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LH60228658	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	60228658	OTHER	WA	LMHC

General Provider Information

NPI Number	:	1295965747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENIFER LEHNE FERGUSON MA

Provider Business Mailing Address
First Line	:	5470 SHILSHOLE AVE NW STE 510
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98107-4040
Country	:	US
Telephone Number	:	206-619-7628
Fax Number	:

Provider Business Practice Location Address
First Line	:	5470 SHILSHOLE AVE NW STE 510
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98107-4040
Country	:	US
Telephone Number	:	206-619-7628
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2009
Last Update Date	:	12/14/2019

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