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1063573657
MARY K DIETRICH
PORTLAND, OR
NPI
1063573657
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Former Name
MARY K GARNER
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
367A00000X Advanced Practice Midwife
(Licence: OR 085077551N5)
Enumeration Date
2006-12-13
Last Update Date
2007-07-08
Business Address
-- MARY K DIETRICH CNM
2705 E BURNSIDE ST SUITE 114
PORTLAND, OR 97214-1763
Phone number: 503-215-6262
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Mailing Address
-- MARY K DIETRICH CNM
PO BOX 3178
PORTLAND, OR 97208-3178
Phone number:
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