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General NPI Number Information
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NPI Number | 1811322456
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Entity Type | Individual
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Provider Name | GRETCHEN A DICKSON ARNP
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Gender | Female
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Dates
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Enumeration Date | 09/12/2013
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Last Update Date | 05/24/2016
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Provider Practice Location Address
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Address Line | 2102 CARRIAGE ST SW SUITE H
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City | OLYMPIA
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State | WA
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Zip | 98502-1049
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Country | US
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Telephone | 360-352-0711
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Fax | 360-705-5048
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Provider Business Mailing Address
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Address Line | 2102 CARRIAGE ST SW SUITE H
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City | OLYMPIA
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State | WA
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Zip | 98502-1049
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Country | US
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Telephone | 360-352-0711
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Fax | 360-705-5048
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP30004516
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License Number State | WA
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