Provider Demographics
NPI:1821690314
Name:FERGUSON, MARKETTA BERNICE (CHILDBIRTH EDUCATOR)
Entity Type:Individual
Prefix:
First Name:MARKETTA
Middle Name:BERNICE
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:CHILDBIRTH EDUCATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 174TH ST S
Mailing Address - Street 2:
Mailing Address - City:SPANAWAY
Mailing Address - State:WA
Mailing Address - Zip Code:98387-8237
Mailing Address - Country:US
Mailing Address - Phone:253-273-2172
Mailing Address - Fax:
Practice Address - Street 1:121 174TH ST S
Practice Address - Street 2:
Practice Address - City:SPANAWAY
Practice Address - State:WA
Practice Address - Zip Code:98387-8237
Practice Address - Country:US
Practice Address - Phone:253-273-2172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty