NPIMap

Organization Active NPI

Fern Life Center LLC

  • Registered Nurse
  • Issaquah, WA
National Provider Identifier
1285871657
Registry record updated Oct 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
AP30006769 Issued in WA
Legal business name
FERN LIFE CENTER LLC
Practice address
710 5TH Ave NW
Issaquah, WA 98027-2823
Phone
(425) 391-3376
NPI assigned
Jan 7, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Keesha Ewers, ARNPNPI 1083769772
Title
Ceo
Phone
(425) 391-3376

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X AP30006769 WA Primary

Addresses

Primary practice location

710 5TH Ave NW
Issaquah, WA 98027-2823

Mailing address

710 5TH Ave NW
Issaquah, WA 98027-2823
Phone (425) 391-3376

National Provider Directory

National Provider Directory
Tax ID family
Fern Life Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

710 5th Ave NW
Issaquah, WA 98027
Phone (425) 391-3376

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1231286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256169600000",
    "number": "1285871657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 5TH AVE NW",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272823",
            "telephone_number": "425-391-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 5TH AVE NW",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272823",
            "telephone_number": "425-391-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERN LIFE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-07",
        "last_updated": "2009-10-22",
        "status": "A",
        "authorized_official_last_name": "EWERS",
        "authorized_official_first_name": "KEESHA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "425-391-3376",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "AP30006769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.