Tri-Cities Infusion and Wellness Clinic

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

TRI-CITIES INFUSION AND WELLNESS CLINIC

Practice address

7211 W Deschutes Ave Ste D202
Kennewick, WA 99336-7715

Phone

(435) 668-3443

NPI assigned

Mar 7, 2019

Last updated

Jul 18, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tyler Thornock, CRNANPI 1881999639

Title

Govenor

Phone

(435) 668-4334

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Tyler Rex Thornock, CRNA

  • Certified Registered Nurse Anesthetist
  • Kennewick, WA
  • NPI 1881999639
  NPD (past) Authorized official

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

{
    "created_epoch": "1551916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563408000000",
    "number": "1417415530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15205 S MOUNTAIN RIDGE CT",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993388325",
            "telephone_number": "435-668-4334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7211 W DESCHUTES AVE STE D202",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367715",
            "telephone_number": "435-668-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-CITIES INFUSION AND WELLNESS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-07",
        "last_updated": "2019-07-18",
        "status": "A",
        "authorized_official_last_name": "THORNOCK",
        "authorized_official_first_name": "TYLER",
        "authorized_official_title_or_position": "GOVENOR",
        "authorized_official_telephone_number": "435-668-4334",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tri-Cities Community Health (Tri-Cities Community Health Behavioral Medicine)
• Tri-Cities Community Health
• Tri-Cities Digestive Health Center, PS
• Tri-Cities Eyecare Center LLC
• Tri-Cities Home Health, LLC (Tri Cities Home Health)
• Tri-Cities Laboratory LLC
• Tri-Cities Laboratory LLC
• Tri-Cities Laboratory LLC
• Tri-Cities Laboratory, LLC
• Tri-Cities Laboratory, LLC

• Nurse Practitioner in Kennewick, WA
• Providers in Kennewick, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 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.