Individual
DR. JON R TIESSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1100 SW BOWMER ST, SUITE A-103, OAK HARBOR, WA 98277-3119
(360) 679-3117
(360) 679-3118
Mailing address
4607 CYPRESS DR, ANACORTES, WA 98221-1114
(360) 293-9765
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO00000673
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1119163
—
WA
Enumeration date
08/10/2006
Last updated
07/21/2008
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