Provider Demographics
NPI:1053096693
Name:TORCHILO, FEDOR VYACHESLAVOVICH (DNP)
Entity type:Individual
Prefix:
First Name:FEDOR
Middle Name:VYACHESLAVOVICH
Last Name:TORCHILO
Suffix:
Gender:M
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 E KINCAID ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-4127
Mailing Address - Country:US
Mailing Address - Phone:360-424-4111
Mailing Address - Fax:
Practice Address - Street 1:307 S 13TH ST STE 300
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-4100
Practice Address - Country:US
Practice Address - Phone:360-336-9757
Practice Address - Fax:360-814-5237
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61475547363LA2100X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care