Individual
MARLENE DIETRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
505 NE 87TH AVE, STE. 460, VANCOUVER, WA 98664-1989
(360) 514-7771
(360) 514-7769
Mailing address
505 NE 87TH AVE, STE. 460, VANCOUVER, WA 98664-1989
(360) 514-7771
(360) 514-7769
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD00035866
WA
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
MD00035866
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8222481
—
WA
Enumeration date
03/23/2006
Last updated
04/09/2013
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