Individual
JENNIFER DIETZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LDO
Contact information
Practice address
14505 NE FOURTH PLAIN BLVD, VANCOUVER, WA 98682-5003
(360) 258-2651
(360) 896-7308
Mailing address
14505 NE FOURTH PLAIN BLVD, VANCOUVER, WA 98682-5003
(360) 258-2651
(360) 896-7308
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DO60887277
WA
Other
Enumeration date
01/01/2024
Last updated
01/01/2024
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