| John L. Diller, Md | |
|
610 S Meridian Puyallup WA 98371-5908 | |
| (253) 845-2629 | |
| (253) 845-2433 |
| Full Name | John L. Diller, Md |
|---|---|
| Speciality | Clinic/center |
| Location | 610 S Meridian, Puyallup, Washington |
| Authorized Official Name and Position | John L Diller (OWNER) |
| Authorized Official Contact | 2538452629 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John L. Diller, Md 610 S Meridian Puyallup WA 98371-5908 Ph: (253) 845-2629 | John L. Diller, Md 610 S Meridian Puyallup WA 98371-5908 Ph: (253) 845-2629 |
| NPI Number | 1982924767 |
|---|---|
| Provider Enumeration Date | 06/03/2010 |
| Last Update Date | 06/03/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982924767 | NPI | - | NPPES |
| 1217207 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 00013892 (Washington) | Primary |
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