Organization
FRED THYSELL MD
Active
Other names
FREDERICK THYSELL
Organization subpart
No
Provider details
NPI number
Authorized official
FREDERICK JARL THYSELL MD (OWNER/DOCTOR)
(509) 823-3861
Entity
Organization
Contact information
Practice address
2807 W WASHINGTON AVE STE 117, YAKIMA, WA 98903-1367
(509) 469-1903
(509) 469-1905
Mailing address
PO BOX 8051, YAKIMA, WA 98908-0051
(509) 469-1903
(509) 469-1905
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1006757
—
WA
Enumeration date
01/18/2019
Last updated
01/18/2019
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