Individual
ANGELA DEE FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
22 W MAIN ST, WALLA WALLA, WA 99362
(509) 529-2020
(509) 529-2115
Mailing address
PO BOX 1138, 22 W MAIN ST, WALLA WALLA, WA 99362
(509) 529-2020
(509) 529-2115
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3572TX
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022886005
REGENCE OREGON
OR
01
—
032340000
CIGNA
—
01
—
0323400001
MC SUPPLY CIGNA DMERC
—
01
—
140327
DEPT OF LABOR AND INDUSTR
—
05
—
2023836
—
WA
01
—
257622800
GROUP HEALTH
—
01
—
3044FE
REGENCE WASHINGTON
WA
01
—
410045308
TRAVELERS MEDICARE
—
01
—
610605300
DEPT OF LABOR SEATTLEDFEC
—
01
—
7753255
AETNA
—
01
—
8886644808
COMMUNITY HEALTH PLAN
WA
01
—
U82129
VISION SERVICE PLAN
—
Enumeration date
03/08/2006
Last updated
12/21/2023
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