ROBERT J DIEDERICH (NPI# 1760678163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760678163 |
| Entity Type | Individual |
| Full Name | ROBERT J DIEDERICH |
| Credential | M.D. |
| Practice Address |
525 Lilly Rd Ne Olympia WA 98506-5101 |
| Practice Telephone | 3604937230 |
| Practice Fax Number | 3604935524 |
| Mailing Telephone | 3604937230 |
| Mailing Fax Number | 3604935524 |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2007-09-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | ML20008010 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | DEA | FD0447652 | 01 |
| Street Address |
525 LILLY RD NE |
| City | OLYMPIA |
| State | WA |
| Zip Code | 98506-5101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861493884 | Suzanne Ellen Woodsum-reed | Social Worker | 525 Lilly Rd Ne, Olympia, WA 98506-5101 | 2005-08-02 |
| 1730702432 | Chanel Wood | Student in an Organized Health Care Education/Training Program | 525 Lilly Rd Ne, Suite 204, Olympia, WA 98506 | 2020-05-28 |
| 1982227062 | Jairo Enrigue Mendoza Briceno | Student in an Organized Health Care Education/Training Program | 525 Lilly Rd Ne, Suite 204, Olympia, WA 98506-5101 | 2020-05-22 |
| 1598384901 | Junun Bae | Student in an Organized Health Care Education/Training Program | 525 Lilly Rd Ne, Olympia, WA 98506-5101 | 2020-04-15 |
| 1205484813 | Neighborcare Health | Clinic/Center | 525 Lilly Rd Ne, Olympia, WA 98506-5101 | 2019-08-27 |
| 1972158210 | Erik Gilbert Gunderson | Pharmacist | 525 Lilly Rd Ne, Olympia, WA 98506-5101 | 2019-08-05 |
| 1215595509 | Hieu Thi Minh Duong | Family Medicine | 525 Lilly Rd Ne, Olympia, WA 98506-5101 | 2019-05-31 |
| 1255998324 | Fang-yu Lee | Family Medicine | 525 Lilly Rd Ne, Olympia, WA 98506-5101 | 2019-05-23 |
| 1588221642 | Jennifer Jean Goodrich | Family Medicine | 525 Lilly Rd Ne, Olympia, WA 98506-5101 | 2019-05-23 |
| 1831756998 | Ryan Edel Kuhar | Family Medicine | 525 Lilly Rd Ne, Olympia, WA 98506-5101 | 2019-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477185460 | Chloe Harper | Technician, Other | 3443 Lilly Rd Se, Ste B, Olympia, WA 98506 | 2020-02-07 |
| 1912543539 | Jessica Marie Radakovich | Licensed Practical Nurse | 3426 Mary Elder Rd, Olympia, WA 98506 | 2019-11-19 |
| 1669014973 | Arlene Josephine Adams | Registered Nurse | 413 Lily Rd Ne, Olympia, WA 98506 | 2019-10-09 |
| 1861999120 | Debra Delores Barker | Licensed Practical Nurse | 3710 South Bay Rd Ne, Olympia, WA 98506 | 2018-04-12 |
| 1801304431 | Michelle Warner | Nurse Practitioner | 205 Lilly Rd Ne Ste A1, Olympia, WA 98506 | 2018-01-17 |
| 1396258364 | Institute for Family Development | Community/Behavioral Health | 204 Quince St. Ne, Suite 200, Olympia, WA 98506 | 2017-11-13 |
| 1083137715 | Cameron Kunkel | Specialist/Technologist | 2512 20th Ave Ne, Olympia, WA 98506 | 2017-07-25 |
| 1184144768 | Trevor Shane Kwan | Family Medicine | 525 Lilly Road Ne, Olympia, WA 98506 | 2017-06-23 |
| 1073043212 | Michael H Harburg | Behavior Technician | 3857 Martin Way Ne, Olympia, WA 98506 | 2017-06-19 |
| 1780114371 | Priscilla Kangyang Jadu | Counselor | 3857 Martin Way E., Olympia, WA 98506 | 2017-06-15 |
| Find all providers in zip 98506 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154974368 | Unruhly Medicine Pllc | Family Medicine | 1701 4th Ave E, Olympia, WA 98506-4533 | 2019-07-17 |
| 1104340405 | Sweet Medical Group, Pllc | Family Medicine | 8315 Normandy St Se, Olympia, WA 98504-0001 | 2017-07-28 |
| 1184144768 | Trevor Shane Kwan | Family Medicine | 525 Lilly Road Ne, Olympia, WA 98506 | 2017-06-23 |
| 1285018432 | South Sound Medical Group, Pllc | Family Medicine | 10116 Coachman Ln Se, Olympia, WA 98501-9731 | 2015-07-17 |
| 1710378229 | Mary Gibbons | Family Medicine | 7040 Puget Beach Rd Ne, Olympia, WA 98516-9158 | 2015-02-05 |
| 1588095749 | Coral Hilby | Family Medicine | 2520 Island Dr Nw, Olympia, WA 98502-9749 | 2013-12-12 |
| 1053756999 | Anna Maria A. Pletz | Family Medicine | 525 Lilly Rd Ne # 250, Pmg Sw Wa East Olympia Fam Med, Olympia, WA 98506-5101 | 2013-05-06 |
| 1811330673 | Eugen Sine Enterprises Inc | Family Medicine | 2121 Stillwater Ave Nw, Olympia, WA 98507 | 2013-04-11 |
| 1972877736 | Eric Richard Houghton | Family Medicine | 1832 Lakewood Cir Se, Olympia, WA 98501-4291 | 2012-02-25 |
| 1073828976 | Lacambra Services Inc | Family Medicine | 7205 Martin Way E, Suite A-69, Olympia, WA 98516-5555 | 2010-08-16 |
| Find all providers in OLYMPIA | ||||
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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.