Provider Demographics
NPI:1982259172
Name:ANDRYSCZYK, TYLER JOHN (PHARM D)
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:JOHN
Last Name:ANDRYSCZYK
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 N MILLER ST
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2041
Mailing Address - Country:US
Mailing Address - Phone:509-663-5336
Mailing Address - Fax:
Practice Address - Street 1:501 N MILLER ST
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-2041
Practice Address - Country:US
Practice Address - Phone:509-663-5336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-05
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60943591183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist