Provider Demographics
NPI:1033146261
Name:CAMDEN-DIEHL, ALISSA D (MD)
Entity Type:Individual
Prefix:DR
First Name:ALISSA
Middle Name:D
Last Name:CAMDEN-DIEHL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:933 RED APPLE RD
Mailing Address - Street 2:STE D
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-3370
Mailing Address - Country:US
Mailing Address - Phone:509-665-6125
Mailing Address - Fax:509-665-6124
Practice Address - Street 1:503 E HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:CHELAN
Practice Address - State:WA
Practice Address - Zip Code:98816-8631
Practice Address - Country:US
Practice Address - Phone:509-682-3300
Practice Address - Fax:509-682-9614
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2024-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00045762207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA244894OtherL & I
WA8950214OtherL & I CRIME VIC
WA8461428Medicaid
WA244894OtherL & I
WAG8880132Medicare PIN