| NPI | 1346496080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS ANNETTE FERGUSON Owner 425-820-2440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP 3001680) |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2008-08-13 |