# FREDERICK J THYSELL MD INC PS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427487255
- **Authorized official:** DR. FREDERICK JARL THYSELL MD (PRESIDENT)
- **Authorized official phone:** (509) 823-3861

## Contact information

- **Practice address:** 1416 JESICA DR, SELAH, WA 98942-1729
- **Practice address phone:** (509) 823-3861
- **Practice address fax:** (509) 697-3819
- **Mailing address:** 1416 JESICA DR, SELAH, WA 98942-1729
- **Mailing address phone:** (509) 823-3861
- **Mailing address fax:** (509) 697-3819

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | MD000024540 | WA | Yes |

## Other

- **Enumeration date:** 11/02/2013
- **Last updated:** 11/02/2013