Dr. Kenneth Anthony Dietrich
Pediatric Critical Care Doctor
600 E Main St
Elma
, Washington 98541-9560
Dr. Kenneth Anthony Dietrich
Pediatric Critical Care Doctor
600 E Main St
Elma
, Washington 98541-9560
(360) 346-2192
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About
Features
Specialties
- Pediatric Critical Care Doctor
Languages spoken
- English
Location
First Address
- Dr. Kenneth Anthony Dietrich
- 600 E Main St
- Elma, WA
- Zip : 98541-9560
- Fax : (360) 346-2192
- Phone : (360) 346-2240
Second Address
- Dr. Kenneth Anthony Dietrich
- 600 E Main St
- Elma, WA
- Zip : 98541-9560
- Fax : (360) 346-2192
- Phone : (360) 346-2240
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080P0203X | Pediatric Critical Care Doctor | 27133 | WA |
National Provider Identifier
| NPI | 1245288752 |
|---|---|
| Provider Name | Dr. Kenneth Anthony Dietrich |
| First Address | Elma, WA 98541-9560 |
| Second Address | Elma, WA 98541-9560 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/05/2006 |
| Last Update Date | 04/04/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.