Individual provider · Type 1 NPI

Thomas Russell Prieskorn, PA-C

Medical Physician Assistant · Shelton, WA

NPI number 1366421174 Active

Practice location

901 Mountain View Dr
Shelton, WA 98584-4401

Call (360) 426-1611 Map

Mailing address

PO Box 1668
Shelton, WA 98584-5001

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA10004942 (WA)

Medical Physician Assistant: Definition to come...

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About NPI 1366421174

Thomas Russell Prieskorn, PA-C's National Provider Identifier is 1366421174, issued on Jan 10, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Shelton, WA. The record was last updated on Mar 3, 2015.