Organization
FERN LIFE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEESHA EWERS ARNP (CEO)
(425) 391-3376
Entity
Organization
Contact information
Practice address
710 5TH AVE NW, ISSAQUAH, WA 98027-2823
(425) 391-3376
Mailing address
710 5TH AVE NW, ISSAQUAH, WA 98027-2823
(425) 391-3376
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
AP30006769
WA
Other
Enumeration date
01/07/2009
Last updated
10/22/2009
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