Individual
KENNETH BIRCH DITTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.S., M.S., P.T.
Contact information
Practice address
3908 CREEKSIDE LOOP, YAKIMA, WA 98902-4877
(509) 576-0100
(509) 576-0101
Mailing address
4205 CASTLEVALE RD, YAKIMA, WA 98908-5603
(509) 576-0100
(509) 576-0101
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00008410
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0196042
LABOR AND INDUSTRIES
WA
01
—
5105BI
REGENCE
WA
01
—
6513370
CIGNA HEALTHCARE
WA
05
—
8424749
—
WA
01
—
8905789
CRIME VICTIMS
WA
Enumeration date
01/25/2006
Last updated
05/15/2020
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