Organization
PHYSICIANS CARE FAMILY MEDICINE INC PS
Active
Other names
Dietrich & Smith Clinic, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
HERBERT EDWIN STICKLE M.D. (ADMINSTRATOR)
(360) 856-4141
Entity
Organization
Contact information
Practice address
1990 HOSPITAL DRIVE, SUITE 100, SEDRO WOOLLEY, WA 98284-9315
(360) 856-4141
(360) 856-4145
Mailing address
1990 HOSPITAL DRIVE, SUITE 100, SEDRO WOOLLEY, WA 98284-9315
(360) 856-4141
(360) 856-4145
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
47990
LABOR & INDUSTRIES
WA
05
—
7080559
—
WA
Enumeration date
01/02/2007
Last updated
08/01/2007
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