MEDICARE: FERGUSON CONSULTING GROUP LLC

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1396381265
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FERGUSON CONSULTING GROUP LLC

Provider Business Mailing Address
First Line	:	2227 57TH ST SE
Second Line	:
City	:	AUBURN
State	:	WA
Zip	:	98092-6521
Country	:	US
Telephone Number	:	360-977-8099
Fax Number	:

Provider Business Practice Location Address
First Line	:	314 182ND AVE E UNIT C
Second Line	:
City	:	LAKE TAPPS
State	:	WA
Zip	:	98391-5704
Country	:	US
Telephone Number	:	360-977-8099
Fax Number	:

Authorized Official
Title or Position	:	OWNER/COUNSELOR
Name	:	RYAN FERGUSON
Credential	:	LMHC
Telephone Number	:	360-977-8099

Provider Enumeration Date	:	11/26/2019
Last Update Date	:	11/26/2019

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