Provider Demographics
NPI:1427810332
Name:DIETHELM, ALINE (BS)
Entity type:Individual
Prefix:
First Name:ALINE
Middle Name:
Last Name:DIETHELM
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5851 NE ALBERTA ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97218-2620
Mailing Address - Country:US
Mailing Address - Phone:503-734-6605
Mailing Address - Fax:
Practice Address - Street 1:5851 NE ALBERTA ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97218-2620
Practice Address - Country:US
Practice Address - Phone:503-734-6605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula