Individual
TYRELL P NIELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2935 ALLEN RD, SUNNYSIDE, WA 98944-8931
(509) 837-0070
(509) 837-0690
Mailing address
2935 ALLEN RD, SUNNYSIDE, WA 98944-8931
(509) 837-0070
(509) 837-0690
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
OA60349888
WA
363A00000X
Physician Assistant
Primary
PA1269
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2010279
—
WA
Enumeration date
08/16/2010
Last updated
12/03/2020
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