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Individual
MICHAEL A DIETER
Active
Individual
MICHAEL A DIETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10002321
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010149524
REGENCE BLUE SHIELD OF ID
ID
01
—
0156193
DEPT OF LABOR & INDUSTRIE
WA
01
—
379109600
OWCP
WA
01
—
4305DI
ASURIS NW HEALTH
WA
01
—
5847
GROUP HEALTH NW
WA
05
—
806174800
—
ID
05
—
8387292
—
WA
01
—
8934606
CRIME VICTIMS
WA
01
—
970027249
RR MEDICARE
WA
01
—
K6401
BLUE CROSS OF ID
ID
Enumeration date
03/14/2006
Last updated
11/15/2024
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