Individual
GRACE TRAAL DILLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
1900 NORTHWEST BLVD STE 210, COEUR D ALENE, ID 83814-2788
(208) 665-5579
Mailing address
1304 E GARLAND AVE, SPOKANE, WA 99207-3038
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
ID000024275E
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ID000024275E
IDAHO DEPARTMENT OF PUBLIC HEALTH AND WELFARE
ID
Enumeration date
10/24/2017
Last updated
10/24/2017
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