Individual
JUSTIN LYLE SICHULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2211 NE 139TH ST, VANCOUVER, WA 98686-2742
(360) 487-1168
(503) 413-7361
Mailing address
109 S PEARL ST APT 2, ELLENSBURG, WA 98926-4002
(509) 856-4968
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD61587710
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
WA
Other
Enumeration date
03/21/2022
Last updated
06/26/2025
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