Individual
MR. IVAN Y DIDYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
13501 NE 28TH ST, VANCOUVER, WA 98682-8091
(360) 604-6775
(360) 604-6777
Mailing address
13501 NE 28TH ST, VANCOUVER, WA 98682-8091
(360) 604-6775
(360) 604-6777
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN60210270
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245311141
—
WA
Enumeration date
09/28/2021
Last updated
09/28/2021
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