Organization
TRI-CITIES INFUSION AND WELLNESS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER THORNOCK CRNA (GOVENOR)
(435) 668-4334
Entity
Organization
Contact information
Practice address
7211 W DESCHUTES AVE STE D202, KENNEWICK, WA 99336-7715
(435) 668-3443
Mailing address
15205 S MOUNTAIN RIDGE CT, KENNEWICK, WA 99338-8325
(435) 668-4334
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/07/2019
Last updated
07/18/2019
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