Provider Demographics
NPI:1649932948
Name:TATSCH, BYRON HUNTER (NP-C)
Entity type:Individual
Prefix:
First Name:BYRON
Middle Name:HUNTER
Last Name:TATSCH
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:801 SW 16TH ST STE 121
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-2628
Mailing Address - Country:US
Mailing Address - Phone:206-538-6300
Mailing Address - Fax:206-538-6301
Practice Address - Street 1:1414 N VERCLER RD STE 5
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-1092
Practice Address - Country:US
Practice Address - Phone:509-381-4500
Practice Address - Fax:509-381-4501
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-13
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61202171363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2195171Medicaid