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Individual

DIANNA LYNN WACHTEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1112 S CUSHMAN AVE, TACOMA, WA 98405-3631
(253) 593-2144
(253) 593-4125
Mailing address
PO BOX 34703, SEATTLE, WA 98124-1703
(206) 764-0112
(206) 764-0489

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10004082
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8362063
WA
Enumeration date
01/17/2007
Last updated
07/08/2007
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