Individual
DR. JEREMY HOWARD DIEHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.D.
Contact information
Practice address
2702 NE 78TH ST, SUITE 108, VANCOUVER, WA 98665-0665
(360) 693-1200
(360) 693-2001
Mailing address
2702 NE 78TH ST, SUITE 108, VANCOUVER, WA 98665-0665
(360) 693-1200
(360) 693-2001
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DE60083669
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1346478906
NATIONAL PROVIDER IDENTIFICATION NUMBER TYPE 2
WA
Enumeration date
07/21/2009
Last updated
05/28/2014
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