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Individual

DR. JAC R TIECHNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
616 N CHELAN AVE, WENATCHEE, WA 98801-2025
(509) 662-2970
(509) 665-9808
Mailing address
616 N CHELAN AVE, WENATCHEE, WA 98801-2025
(509) 662-2970
(509) 665-9808

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO00000207
WA
213ER0200X
Radiology Podiatrist
PO00000207
WA
213ES0103X
Foot & Ankle Surgery Podiatrist
PO00000207
WA
213ES0131X
Foot Surgery Podiatrist
PO00000207
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0035677
WA STATE LABOR AND INDUSTRY GROUP #
WA
05
1013614
WA
01
15520000
WA STATE LABOR AND INDUSTRY
WA
01
480661080
PALMETTO GBA RAILROAD MEDICARE PART B
WA
Enumeration date
06/09/2006
Last updated
05/01/2008
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