MEDICARE: FERN ELIZABETH FELDMAN RN, NP

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	363L00000X	Nurse Practitioner	18326	CA
2	363LF0000X	Family Nurse Practitioner	AP30002263	WA

General Provider Information

NPI Number	:	1932363900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FERN ELIZABETH FELDMAN RN, NP

Provider Business Mailing Address
First Line	:	6323 21ST AVE NE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98115-6915
Country	:	US
Telephone Number	:	206-507-6544
Fax Number	:

Provider Business Practice Location Address
First Line	:	4548 BROOKLYN AVE NE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98105-4537
Country	:	US
Telephone Number	:	206-850-5654
Fax Number	:	206-926-9226

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

Provider Enumeration Date	:	07/17/2008
Last Update Date	:	05/26/2022

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