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Individual

DR. THOMAS S DIETRICH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5009 DUBOIS DR, VANCOUVER, WA 98661-6612
(360) 903-3895
Mailing address
PO BOX 849, VANCOUVER, WA 98666-0849
(360) 903-3895

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4837
AK

Other

Enumeration date
05/11/2007
Last updated
07/08/2007
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