Individual
TETYANA MCILVAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
9177 RIDGETOP BLVD NW, SILVERDALE, WA 98383-8519
(360) 307-6961
Mailing address
9177 RIDGETOP BLVD NW, SILVERDALE, WA 98383-8519
(360) 307-6961
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
DOS1935
HI
Other
Enumeration date
05/02/2017
Last updated
07/09/2021
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