Provider Demographics
NPI:1962423160
Name:TYSHLER, LEANNA B (MD)
Entity type:Individual
Prefix:
First Name:LEANNA
Middle Name:B
Last Name:TYSHLER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:20216 33RD AVE NE
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST PARK
Mailing Address - State:WA
Mailing Address - Zip Code:98155-1539
Mailing Address - Country:US
Mailing Address - Phone:206-363-9668
Mailing Address - Fax:
Practice Address - Street 1:3218 NASSAU ST
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4139
Practice Address - Country:US
Practice Address - Phone:425-259-9225
Practice Address - Fax:425-339-3381
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2021-05-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00040231207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAH97049Medicare UPIN