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Individual

DR. DAVID MICHAEL DEITZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3920 CAPITOL MALL DR SW, SUITE 302, OLYMPIA, WA 98502-8700
(360) 754-3507
(360) 236-1457
Mailing address
PO BOX 9532, TACOMA, WA 98409
(360) 491-5999
(360) 491-5946

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD00025585
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1072552
WA
01
115568
LABOR & INDUSTRY
WA
Enumeration date
05/09/2006
Last updated
03/07/2008
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