Individual
ESTHER FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
802 NE 5TH ST, DUFUR, OR 97021-3034
(310) 293-8940
Mailing address
PO BOX 224, DUFUR, OR 97021-0224
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-AT-10168874
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00
N/A
—
Enumeration date
04/01/2019
Last updated
04/01/2019
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