Provider Demographics
NPI:1053622720
Name:FEDAN, ASHLEY ELIZABETH (CRNA, ANRP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ELIZABETH
Last Name:FEDAN
Suffix:
Gender:F
Credentials:CRNA, ANRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18911 NE 168TH ST
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-6125
Mailing Address - Country:US
Mailing Address - Phone:717-487-4316
Mailing Address - Fax:
Practice Address - Street 1:215 1ST AVE W APT 711
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98119-4257
Practice Address - Country:US
Practice Address - Phone:717-487-4316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-28
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60172251367500000X
PA084279367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered