Individual
REBECCA HELEN SHIDE-FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9330 59TH AVE SW, LAKEWOOD, WA 98499-2858
(253) 581-7020
Mailing address
9330 59TH AVE SW, LAKEWOOD, WA 98499-2858
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP61234713
WA
Other
Enumeration date
10/24/2018
Last updated
12/08/2021
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