NPIMap

Organization Active NPI

Fred Thysell MD

Doing business as Frederick Thysell

  • Family Medicine Physician
  • Yakima, WA
National Provider Identifier
1255805628
Registry record updated Jan 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FRED THYSELL MD
Doing business as
Frederick Thysell
Practice address
2807 W Washington Ave Ste 117
Yakima, WA 98903-1367
Phone
(509) 469-1903
Fax
(509) 469-1905
NPI assigned
Jan 18, 2019
Last updated
Jan 18, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Frederick Jarl Thysell, MDNPI 1285643544
Title
Owner/Doctor
Phone
(509) 823-3861

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

2807 W Washington Ave Ste 117
Yakima, WA 98903-1367

Mailing address

PO Box 8051
Yakima, WA 98908-0051
Phone (509) 469-1903

Other identifiers 1

IdentifierTypeStateIssuer
1006757MedicaidWA

Other names 1

  • FREDERICK THYSELL Doing business as

National Provider Directory

National Provider Directory

Locations

2807 W Washington Ave
Ste 117
Yakima, WA 98903
Phone (509) 452-8418

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1547769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547769600000",
    "number": "1255805628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8051",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989080051",
            "telephone_number": "509-469-1903",
            "fax_number": "509-469-1905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2807 W WASHINGTON AVE STE 117",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989031367",
            "telephone_number": "509-469-1903",
            "fax_number": "509-469-1905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRED THYSELL MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-18",
        "last_updated": "2019-01-18",
        "status": "A",
        "authorized_official_last_name": "THYSELL",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "JARL",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "509-823-3861",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1006757",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FREDERICK THYSELL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FREDERICK THYSELL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.