Individual
ROBERT OWEN DIETZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1217 NE BURNSIDE RD, SUITE 502, GRESHAM, OR 97030-6722
(503) 492-3910
(503) 492-3905
Mailing address
1217 NE BURNSIDE RD, SUITE 502, GRESHAM, OR 97030-6722
(503) 492-3910
(503) 492-3905
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
273650
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
273650
MEDICAL LICENSE
CA
Enumeration date
10/02/2007
Last updated
10/02/2007
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