| Frederick Thysell | |
|
2807 W Washington Ave Ste 117 Yakima WA 98903-1367 | |
| (509) 469-1903 | |
| (509) 469-1905 |
| Full Name | Frederick Thysell |
|---|---|
| Speciality | Family Medicine |
| Location | 2807 W Washington Ave Ste 117, Yakima, Washington |
| Authorized Official Name and Position | Frederick Jarl Thysell (OWNER/DOCTOR) |
| Authorized Official Contact | 5098233861 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Frederick Thysell Po Box 8051 Yakima WA 98908-0051 Ph: (509) 469-1903 | Frederick Thysell 2807 W Washington Ave Ste 117 Yakima WA 98903-1367 Ph: (509) 469-1903 |
| NPI Number | 1255805628 |
|---|---|
| Provider Enumeration Date | 01/18/2019 |
| Last Update Date | 01/18/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255805628 | NPI | - | NPPES |
| 1006757 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Primary |
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