Individual
TIMOTHY DANIEL DIBBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1123 N EVERGREEN RD, SPOKANE VALLEY, WA 99216-1138
(509) 363-3100
(509) 363-0300
Mailing address
PO BOX 808, VERADALE, WA 99037-0808
(509) 363-3100
(509) 363-0300
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
M-7950
ID
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
MD00042632
WA
208VP0014X
Interventional Pain Medicine Physician
M-7950
ID
208VP0014X
Interventional Pain Medicine Physician
MD00042632
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1115443
—
WA
01
—
125300300
US DEPT OF LABOR-OWCP
WA
01
—
157490
LABOR & INDUSTRIES
WA
05
—
805808900
—
ID
01
—
CJ9109
RAILROAD MEDICARE
WA
Enumeration date
11/09/2006
Last updated
07/17/2023
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