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Individual

BRENT G THIEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3726 BROADWAY, STE 201, EVERETT, WA 98201-3788
(425) 317-9119
(425) 317-9118
Mailing address
3726 BROADWAY, STE 201, EVERETT, WA 98201-3788
(425) 317-9119
(425) 317-9118

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
42333
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1019547
WA
Enumeration date
09/16/2006
Last updated
07/26/2021
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