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General NPI Number Information
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NPI Number | 1518908573
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Entity Type | Individual
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Provider Name | JAC R TIECHNER DPM
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Gender | Male
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Dates
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Enumeration Date | 06/09/2006
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Last Update Date | 05/01/2008
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Provider Practice Location Address
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Address Line | 616 N CHELAN AVE
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City | WENATCHEE
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State | WA
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Zip | 98801-2025
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Country | US
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Telephone | 509-662-2970
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Fax | 509-665-9808
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Provider Business Mailing Address
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Address Line | 616 N CHELAN AVE
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City | WENATCHEE
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State | WA
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Zip | 98801-2025
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Country | US
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Telephone | 509-662-2970
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Fax | 509-665-9808
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PO00000207
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO00000207
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 213ER0200X
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Taxonomy Name | Radiology Podiatrist
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License Number | PO00000207
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | PO00000207
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License Number State | WA
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