SearchWashington225700000X

Tyson Mix

NPI 1841676772 · on the registry since 2015 · sole proprietor

Practice

Address
622 S 3rd Ave Sw
Tumwater, WA 98512
Phone
(360) 628-2088

Registry record

Primary taxonomy
225700000X
225700000X
Licence states on file
WA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2015-08-03

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Washington