Individual
ELLEN FERDERER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14120 N NEWPORT HWY, SUITE B, MEAD, WA 99021-8600
(509) 468-4861
(509) 468-2101
Mailing address
16083 SW UPPER BOONES FERRY RD, SUITE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60417278
WA
Other
Enumeration date
02/12/2014
Last updated
02/12/2014
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