Individual
TYCHO E KERSTEN
Active
Individual
TYCHO E KERSTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
MD00039855
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010135813
REGENCE BLUE SHIELD
ID
01
—
0149631
DEPT OF LABOR & INDUSTRIE
WA
01
—
200040948
RR MEDICARE
WA
01
—
22669
GROUP HEALTH NW
WA
01
—
379109600
OWCP
WA
01
—
5030KE
ASURIS NW HEALTH
WA
05
—
806017400
—
ID
05
—
8276586
—
WA
01
—
8928289
CRIME VICTIMS
WA
01
—
KQ803
BLUE CROSS OF IDAHO
ID
Enumeration date
02/28/2006
Last updated
11/20/2024
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