IndividualActive
Kenneth Dietrich, M.D., MBA
NPI 1245288752 · Pediatric Critical Care Medicine Physician · Elma, WA
Provider details
- NPI number
- 1245288752
- Entity type
- Individual
- Primary specialty
- Pediatric Critical Care Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D., MBA
- Sex
- Male
- Sole proprietor
- No
- License
- 27133 (WA)
Practice location
600 E Main St
Elma, WA 98541-9560
Phone: (360) 346-2240
Fax: (360) 346-2192
Mailing address
600 E Main St
Elma, WA 98541-9560
Registry dates
- Enumerated
- 2006-05-05
- Last updated
- 2019-04-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.