Provider Demographics
NPI:1891031548
Name:FERNYHOUGH, WILL S (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:WILL
Middle Name:S
Last Name:FERNYHOUGH
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10050 NE 10TH ST STE C
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-4121
Mailing Address - Country:US
Mailing Address - Phone:425-455-2020
Mailing Address - Fax:425-455-0310
Practice Address - Street 1:10050 NE 10TH ST STE C
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-4121
Practice Address - Country:US
Practice Address - Phone:425-455-2020
Practice Address - Fax:425-455-0310
Is Sole Proprietor?:No
Enumeration Date:2012-12-28
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00005930174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist