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Jayme Dee Fergoda

Social Worker

Behavioral Health & Social Service Providers

1313 E. Maple Street, Ste. 224, Bellingham, WA 98225

PECOS Enrollment

This provider is enrolled in PECOS as JAYME FERGODA.

Based on the most recent information from CMS, provider Jayme Dee Fergoda is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1083882112
Provider Type
Individual
Full Name
Fergoda, Jayme Dee
Credential
PH.D., LICSW

Gender
Female
Sole Proprietor
Yes
Enumeration Date
2/12/2008
Last Updated
8/28/2014

Contact Information

Practice Location

1313 E. Maple Street, Ste. 224, Bellingham, WA 98225

(360) 685-4224

(360) 685-4222

Mailing Location

1313 E. Maple Street, Ste. 224, Bellingham, WA 98225

(360) 685-4224

(360) 685-4222

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License LW00005651 Washington

Jayme Dee Fergoda

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

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Code

Description

License

Code

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