Individual
DR. KYLE EDWARD FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
525 LILLY RD NE, OLYMPIA, WA 98506-5101
(360) 493-7230
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY60129975
WA
Other
Enumeration date
09/13/2010
Last updated
04/25/2018
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