Most Relevant Information
Provider Data
| NPI Number: | 1003696865 |
| Provider Name: | RENEE FERGUSON |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/29/2023 |
| Last Updated: | 09/29/2023 |
Provider Practice Location
10831 VERNON RD
LAKE STEVENS
WA
982588540
Practice Location Phone/Fax
| Phone: | 4255300564 |
| Fax: |
Provider Mailing Location
10831 VERNON RD
LAKE STEVENS
WA
982588540
Provider Mailing Phone/Fax
| Phone: | 4255300564 |
| Fax: |