MEDICARE: PATRICIA RUTH SYLWESTER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	MD24159	WA

General Provider Information

NPI Number	:	1639188824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA RUTH SYLWESTER MD

Provider Business Mailing Address
First Line	:	1801 W BAY DR NW
Second Line	:	SUITE 208A
City	:	OLYMPIA
State	:	WA
Zip	:	98502-4310
Country	:	US
Telephone Number	:	360-870-8616
Fax Number	:	360-208-0620

Provider Business Practice Location Address
First Line	:	1801 W BAY DR NW
Second Line	:	SUITE 208A
City	:	OLYMPIA
State	:	WA
Zip	:	98502-4310
Country	:	US
Telephone Number	:	360-870-8616
Fax Number	:	360-208-0620

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	09/04/2015

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