ELIZABETH JEAN DIETRICH (NPI# 1811056633) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811056633 |
| Entity Type | Individual |
| Full Name | ELIZABETH JEAN DIETRICH |
| Credential | PA |
| Practice Address |
340 9th St Florence OR 97439-9470 |
| Mailing Address |
Po Box 24410 Eugene OR 97402-0451 |
| Practice Telephone | 5419021634 |
| Practice Fax Number | 5419029702 |
| Mailing Telephone | 5419844301 |
| Enumeration Date | 2006-12-07 |
| Last Update Date | 2012-11-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA01118 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | OR STATE BOARD OF NURSING | 200540762RN | 01 |
| OR | OBME LICENSE | PA01118 | 01 |
| OR | 500632421 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154981876 | Elizabeth Dietrich | Social Worker | 2001 The Alameda, San Jose, CA 95126-1136 | 2019-06-14 |
| Street Address |
340 9TH ST |
| City | FLORENCE |
| State | OR |
| Zip Code | 97439-9470 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679567788 | Gina Simone Wilson | Obstetrics & Gynecology | 340 9th St, Florence, OR 97439-9470 | 2005-09-02 |
| 1245649029 | Mark Daniels | Registered Nurse | 340 9th St, Florence, OR 97439 | 2014-08-06 |
| 1336431881 | Charles Anthony Saltalamacchia | Obstetrics & Gynecology | 340 9th St, Florence, OR 97439-9470 | 2011-05-03 |
| 1972773547 | Sarah Ann Zimmerman | Counselor | 340 9th St, Florence, OR 97439-9470 | 2008-03-10 |
| 1568502672 | Barbara C Anderson | Nurse Practitioner | 340 9th St, Florence, OR 97439-9470 | 2007-02-07 |
| 1528005253 | Peggy Lisa Mccullum | Advanced Practice Midwife | 340 9th St, Florence, OR 97439-9470 | 2006-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417586488 | Kelcie-may S Toledo | Pharmacist | 700 Us-101, Florence, OR 97439 | 2020-04-02 |
| 1144875444 | Steven Mee | Dentist | 1225 Us - 101, Florence, OR 97439 | 2019-08-05 |
| 1164944351 | Karie James | Massage Therapist | 2010 11th St, Florence, OR 97439 | 2017-07-10 |
| 1205266046 | Deborah Lynne Grigsby | Counselor | 1490 1st Street, Unit #1, Florence, OR 97439 | 2013-11-14 |
| 1811247398 | Luke Henry | Occupational Therapist | 1951 East 21st Street, Florence, OR 97439 | 2012-09-12 |
| 1144589102 | Ryan Charles Korando | Denturist | 1705 22nd Street, Florence, OR 97439 | 2012-05-11 |
| 1568728640 | Deborah Lynn Pasternak | Massage Therapist | 1495 8th Street, Suite C, Florence, OR 97439 | 2012-04-03 |
| 1275844185 | Serena Appel | Counselor | 1525 12th St Ste 8, Florence, OR 97439 | 2010-06-24 |
| 1669702056 | Monarch Medical Group LLC | Clinic/Center | 2775 Hwy 101, Suite B, Florence, OR 97439 | 2010-01-06 |
| 1871722231 | Aen Brauer | Social Worker | 1445 W 8th St, Florence, OR 97439 | 2009-07-07 |
| Find all providers in zip 97439 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508429317 | Charlotte H. Hanna | Physician Assistant | 800 E Cheves St Ste 380, Florence, SC 29506-2649 | 2019-04-17 |
| 1386831261 | Andrea Aquadro | Physician Assistant | 204 Ana Dr Ste B, Florence, AL 35630-1750 | 2007-09-25 |
| 1871596247 | Katherine E Walton-vecchio | Physician Assistant | 70 Main St, Florence, MA 01062-1466 | 2005-05-31 |
| 1073161634 | Whitney Lenore Sims | Physician Assistant | 101 William H Johnson St Ste 600, Florence, SC 29506-2773 | 2019-08-27 |
| 1295382059 | Kristina M Washington | Physician Assistant | 360 N Irby St, Florence, SC 29501-2808 | 2019-08-26 |
| 1083194658 | Laura Goldstein | Physician Assistant | 70 Main St, Florence, MA 01062-1487 | 2018-08-14 |
| 1962910026 | Joshua James Rogers | Physician Assistant | 2908 Mall Rd, Florence, AL 35630-1641 | 2018-01-10 |
| 1487186037 | Joseph Zachary Dedden | Physician Assistant | 8726 Us 42, Florence, KY 41042-9625 | 2017-04-03 |
| 1588905624 | Katie F Smith | Physician Assistant | 1929a Mountain Laurel Ct, Florence, SC 29505-6053 | 2013-03-14 |
| 1588922918 | Shelly Springer Kindahl | Physician Assistant | 2471 Helton Dr, Florence, AL 35630-1067 | 2012-04-23 |
| Find all providers in FLORENCE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.