Provider Demographics
NPI:1417138983
Name:LEDGERWOOD, ASHLEY MARIE (TECH)
Entity Type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:MARIE
Last Name:LEDGERWOOD
Suffix:
Gender:F
Credentials:TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 228TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98074-7226
Mailing Address - Country:US
Mailing Address - Phone:425-868-1112
Mailing Address - Fax:425-868-0170
Practice Address - Street 1:526 228TH AVE NE
Practice Address - Street 2:
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98074-7226
Practice Address - Country:US
Practice Address - Phone:425-868-1112
Practice Address - Fax:425-868-0170
Is Sole Proprietor?:No
Enumeration Date:2007-11-26
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH61370380183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAVA00071649OtherWA STATE LICENSE