Provider Demographics
NPI:1023392974
Name:FERGUSON, SHAWN VIOLET (DVM)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:VIOLET
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14810 15TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155-7126
Mailing Address - Country:US
Mailing Address - Phone:206-204-3366
Mailing Address - Fax:
Practice Address - Street 1:14810 15TH AVE NE
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98155-7126
Practice Address - Country:US
Practice Address - Phone:206-204-3366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAVT00007361174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian