Individual
JACKLYN JOAN TRYHUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
900 N ORANGE ST STE 202, MISSOULA, MT 59802-2951
(406) 327-3362
(406) 327-3349
Mailing address
PO BOX 12, LIBERTY LAKE, WA 99019-0012
(406) 327-3362
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1168101
MT
363A00000X
Physician Assistant
Primary
MED-PAC-LIC-80060
MT
Other
Enumeration date
09/24/2019
Last updated
03/21/2022
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