Individual
SHANON TYSLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPTL
Contact information
Practice address
4030 ALDERWOOD MALL BLVD, LYNNWOOD, WA 98036
(425) 776-0803
(425) 776-0813
Mailing address
4030 ALDERWOOD MALL BLVD, LYNNWOOD, WA 98036
(425) 776-0803
(425) 776-0813
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT00008170
WA
Other
Enumeration date
07/07/2005
Last updated
02/10/2015
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