David Allen Dietrick, PHARM D

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

PH60197555 Issued in WA

Practice address

914 S Scheuber Rd
Centralia, WA 98531-9027

Phone

(360) 330-8785

Fax

(360) 330-8684

NPI assigned

Jun 22, 2012

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340323200000",
    "number": "1033472089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7433 44TH AVE NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985162763",
            "telephone_number": "231-388-1848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 S SCHEUBER RD",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985319027",
            "telephone_number": "360-330-8785",
            "fax_number": "360-330-8684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETRICK",
        "first_name": "DAVID",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-22",
        "last_updated": "2012-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MI",
            "license": "5302034463",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "FL",
            "license": "PS42991",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "CO",
            "license": "PHA-18176",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "WA",
            "license": "PH60197555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eileen Kuo Deskins, D.D.S.
• Dave Watson Devaughn
• Franklin Day Devaul
• Kayla Rose Devine, M.A., CCC-SLP
• Kelley Devoe
• Discovery Therapeutic Services LLC
• Danielle Renee Dobbs, SUDPT
• Doc Pharmacy Services
• Joseph L. Dolezal, OD
• Patricia Sue Dolezal, PT

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Centralia, WA
• Providers in Centralia, WA by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.