Dietzgen, Stacy Melissa

Dietzgen, Stacy Melissa is an individual health care provider with primary practice located at 1959 Ne Pacific St , Seattle WA 98195-0001. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is her primary health care specialty. Dietzgen, Stacy Melissa can be contacted via phone (206) 598-4333.

Contact Information

Primary practice address
1959 Ne Pacific St Seattle WA 98195-0001
Phone: (206) 598-4333
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD60492901 Washington
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X MD60492901 Washington

Profile Details

NPI number 1487920575
LBN Legal business name Dietzgen, Stacy Melissa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 22nd, 2012
Last updated Dec 15th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487920575 NPPES
Washington MEDICAID 1487920575

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