Dr. Kenneth Anthony Dietrich
M.D., MBA | Pediatric Critical Care Medicine | Male
Dr. Kenneth Anthony Dietrich, M.D., MBA is a Elma, Washington based Pediatric doctor with medical specialization in
Pediatric Critical Care Medicine.
Current practice location of Dr. Kenneth Anthony Dietrich is
600 E Main St, Elma, Washington - 98541-9560. He can be contacted on phone at
360-346-2240 and fax number 360-346-2192.
Dr. Kenneth Anthony Dietrich is a sole proprietor of his business.
NPI number (Unique professional ID) for Dr. Kenneth Anthony Dietrich is
1245288752 which was assigned by NPPES on 05 May, 2006 and it was last updated on 04 Apr, 2019.
Dr. Kenneth Anthony Dietrich license number is
27133 for Pediatrics Pediatric Critical Care Medicine (2080P0203X) in Washington.
Dr. Kenneth Anthony Dietrich is expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.
Complete Profile:
Dr. Kenneth Anthony Dietrich basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Pediatric Critical Care Medicine |
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| Provider Name : | Dr. Kenneth Anthony Dietrich |
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| Credential : | M.D., MBA |
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| Gender : | Male |
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Business Address:
Dr. Kenneth Anthony Dietrich address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 600 E Main St
Elma, WA, 98541-9560
United States |
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| Phone Number : | 360-346-2240 |
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| Fax Number : | 360-346-2192 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1245288752 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 05 May, 2006 |
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| Last Updated On : | 04 Apr, 2019 |
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Medicare Participation:
Dr. Kenneth Anthony Dietrich participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.
| Medicare PECOS ID : | 1658275482 |
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| Medicare Enrollment ID : | I20050623000139 |
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| Primary Specialty : | Pediatric Medicine |
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| Medical School : | Louisiana State University School Of Medicine In New Orleans |
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| Graduation Year : | 1982 |
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| Accepts Medicare? | Yes. Dr. Kenneth Anthony Dietrich accepts medicare insurance. |
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Group Practice Association:
Dr. Kenneth Anthony Dietrich is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Dr. Kenneth Anthony Dietrich is associated with along with the number of members in that group. He may also accept medicare indirectly via these group practices.
| Organisation Name : | Group Practice ID | No. of Members | Practice Address | Group Accepts Medicare |
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| Grays Harbor County Public Hospital District No 1 | 9032017256 | 32 | 600 E Main St
Elma, WA - 985419560
Ph: 3603462222 | Yes |
Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Kenneth Anthony Dietrich are as mentioned. Primary taxonomy code for Dr. Kenneth Anthony Dietrich, M.D., MBA is
2080P0203X (Pediatrics Pediatric Critical Care Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
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| 2080P0203X | Pediatrics Pediatric Critical Care Medicine | Yes | 27133 | WA |
Other Practice Locations:
| Practice Address | City, State | Phone Number |
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314 MARTIN LUTHER KING JR WAY, SUITE 9
TACOMA, WA, 98405-4250
United States | TACOMA, WA | 253-403-1511 |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 600 E Main St
Elma, WA, 98541-9560
United States |
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| Phone Number : | 360-346-2240 |
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| Fax Number : | 360-346-2192 |
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Business Location:
Patients can refer following map for directions to
Dr. Kenneth Anthony Dietrich practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.