Individual
DANIEL DITLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPC
Contact information
Practice address
6604 MARTIN WAY E, OLYMPIA, WA 98516-5542
(360) 639-7002
(360) 639-0920
Mailing address
280 W ST SE, TUMWATER, WA 98501-5202
(564) 225-7596
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
175T00000X
Peer Specialist
—
—
Other
Enumeration date
07/19/2024
Last updated
07/19/2024
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