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Individual

JACOB THEODORE DIDESCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
820 N CHELAN AVE, WENATCHEE, WA 98801
(509) 663-8711
Mailing address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
(509) 663-8711

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
MD60846859
WA
2086S0105X
Surgery of the Hand (Surgery) Physician
Primary
MD60846859
WA

Other

Enumeration date
03/28/2012
Last updated
09/21/2018
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