Organization
ASHLEY FEDAN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY E FEDAN CRNA (PROVIDER/OWNER)
(717) 487-4316
Entity
Organization
Contact information
Practice address
111 S 13TH ST, MOUNT VERNON, WA 98274-4105
(360) 336-2178
Mailing address
PO BOX 97115, LAKEWOOD, WA 98497-0115
(253) 588-7911
(253) 365-6299
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP60172251
LICENSE
WA
Enumeration date
08/16/2013
Last updated
08/17/2016
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