Provider Demographics
NPI:1396211447
Name:FERGUSON, ANDREW CHRISTOPHER
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:CHRISTOPHER
Last Name:FERGUSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 S GRANT ST
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-2013
Mailing Address - Country:US
Mailing Address - Phone:702-630-6297
Mailing Address - Fax:
Practice Address - Street 1:520 S GRANT ST
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-2013
Practice Address - Country:US
Practice Address - Phone:702-630-6297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-16
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist