Fernando Dietsch Jr. (NPI# 1962455535, PAC ID# 6507888559) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY PRACTICE.
| Nation Provider ID (NPI) | 1962455535 |
| PAC ID by PECOS | 6507888559 |
| Professional Enrollment ID | I20051219000996 |
| Full Name | Fernando Dietsch Jr. |
| Organization Legal Name | GRANT COUNTY PUBLIC HOSPITAL DISTRICT 2 |
| Address |
908 10th Ave Sw Quincy WA 98848-1376 |
| Phone Number | 5097873531 |
| Gender | M |
| Credential | MD |
| Graduation Year | 1996 |
| Primary Specialty | FAMILY PRACTICE |
| Group Practice PAC ID | 8921919077 |
| Number of Group Practice Members | 12 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 501320 | QUINCY VALLEY HOSPITAL |
| 501330 | SUNNYSIDE COMMUNITY HOSPITAL |
| 380052 | SAINT ALPHONSUS MEDICAL CENTER - ONTARIO, INC |
| Address | Phone | Organization |
|---|---|---|
| 908 10th Ave Sw, Quincy, WA 98848-1376 | 5097873531 | GRANT COUNTY PUBLIC HOSPITAL DISTRICT 2 |
| 1016 Tacoma Ave, Sunnyside, WA 98944-2263 | 5098371707 | SUNNYSIDE EMERGENCY GROUP A PROFESSIONAL LLC |
| Organization Legal Name | GRANT COUNTY PUBLIC HOSPITAL DISTRICT 2 |
| Physicians | 6 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mary C Klingner | Family Medicine | Grant County Public Hospital District 2 | 908 10th Ave Sw, Quincy, WA 98848-1376 |
| Jaime D Dominguez-cespedes | Internal Medicine | Grant County Public Hospital District 2 | 908 10th Ave Sw, Quincy, WA 98848-1376 |
| Terri L Johnson | Nurse Practitioner | Grant County Public Hospital District 2 | 908 10th Ave Sw, Quincy, WA 98848-1376 |
| Elaine E Polk | Physician Assistant | Grant County Public Hospital District 2 | 908 10th Ave Sw, Quincy, WA 98848-1376 |
| William J Washington | Emergency Medicine | Grant County Public Hospital District 2 | 908 10th Ave Sw, Quincy, WA 98848-1376 |
| Street Address |
908 10TH AVE SW |
| City | QUINCY |
| State | WA |
| Zip | 98848-1376 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mary C Klingner | Family Medicine | Grant County Public Hospital District 2 | 908 10th Ave Sw, Quincy, WA 98848-1376 |
| Jaime D Dominguez-cespedes | Internal Medicine | Grant County Public Hospital District 2 | 908 10th Ave Sw, Quincy, WA 98848-1376 |
| Terri L Johnson | Nurse Practitioner | Grant County Public Hospital District 2 | 908 10th Ave Sw, Quincy, WA 98848-1376 |
| Elaine E Polk | Physician Assistant | Grant County Public Hospital District 2 | 908 10th Ave Sw, Quincy, WA 98848-1376 |
| William J Washington | Emergency Medicine | Grant County Public Hospital District 2 | 908 10th Ave Sw, Quincy, WA 98848-1376 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Randy R Zolman | Chiropractic | 110 C St Sw, Quincy, WA 98848-1207 |
| City | QUINCY |
| Zip Code | 98848 |
| Specialty | FAMILY PRACTICE |
| City + Specialty | QUINCY + FAMILY PRACTICE |
Please comment or provide details below to improve the information on Fernando Dietsch Jr..
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.