Lysack, Glenn Joseph

Lysack, Glenn Joseph is an individual health care provider with primary practice located at 1400 Farragut Ave Bldg 940 , Bremerton WA 98314-6001. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Lysack, Glenn Joseph can be contacted via phone (360) 476-6872.

Contact Information

Primary practice address
1400 Farragut Ave Bldg 940 Bremerton WA 98314-6001
Phone: (360) 476-6872
Fax: (360) 476-6872
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA3242 Florida

Profile Details

NPI number 1578501094
LBN Legal business name Lysack, Glenn Joseph
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 4th, 2006
Last updated Aug 14th, 2026 - about 2 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1578501094 NPPES
Florida MEDICAID 292120100

Popular Providers