MEDICARE: MS. SANDRA LYNN FERENCY CNMT

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	2471N0900X	Nuclear Medicine Technology Radiologic Technologist	RT00003990	WA

General Provider Information

NPI Number	:	1457452443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SANDRA LYNN FERENCY CNMT

Provider Business Mailing Address
First Line	:	8526 220TH ST SW
Second Line	:
City	:	EDMONDS
State	:	WA
Zip	:	98026-8130
Country	:	US
Telephone Number	:	425-672-4741
Fax Number	:

Provider Business Practice Location Address
First Line	:	1015 8TH AVE N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98109-3504
Country	:	US
Telephone Number	:	206-287-3900
Fax Number	:	206-287-3905

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

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	07/08/2007

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