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General NPI Number Information
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NPI Number | 1407634967
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Entity Type | Individual
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Provider Name | ADAM JOSEPH DINIUS PA-C
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Gender | Male
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Dates
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Enumeration Date | 09/18/2023
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Last Update Date | 09/18/2023
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Provider Practice Location Address
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Address Line | 1901 S UNION AVE STE B3003
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City | TACOMA
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State | WA
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Zip | 98405-1803
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Country | US
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Telephone | 253-572-2842
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Fax |
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Provider Business Mailing Address
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Address Line | 22120 116TH AVE SE
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City | KENT
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State | WA
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Zip | 98031-2313
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Country | US
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Telephone | 253-293-6516
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA.PA.61479624
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License Number State | WA
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