Provider Demographics
NPI:1659182079
Name:FERDERER, MICHELLE LEANNE (ARNP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LEANNE
Last Name:FERDERER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:MICHEL
Other - Middle Name:LEANNE
Other - Last Name:PARMELY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3708 N WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-3058
Mailing Address - Country:US
Mailing Address - Phone:509-859-7365
Mailing Address - Fax:
Practice Address - Street 1:2401 W WELLESLEY AVE STE D
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-5009
Practice Address - Country:US
Practice Address - Phone:509-598-7870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61633130363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily