Individual
MR. JOHN LEWIS DILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
610 S MERIDIAN, PUYALLUP, WA 98371
(253) 845-2629
(253) 845-2433
Mailing address
610 S MERIDIAN, PUYALLUP, WA 98371
(253) 845-2629
(253) 845-2433
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00013892
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1217207
—
WA
01
—
140045140045
PREMERA BLUE CROSS
WA
01
—
DI1840
REGENCE
WA
Enumeration date
11/30/2006
Last updated
05/20/2008
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