Provider Demographics
NPI:1326513433
Name:DIEKER, LENDELYN E (PHARMD, MBA, MPH)
Entity Type:Individual
Prefix:DR
First Name:LENDELYN E
Middle Name:
Last Name:DIEKER
Suffix:
Gender:F
Credentials:PHARMD, MBA, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9233 PAINTBRUSH LN
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808-9623
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4003 CREEKSIDE LOOP
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-3962
Practice Address - Country:US
Practice Address - Phone:509-573-3808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-05
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTPHA-PHA-LIC-54917183500000X
WAPH60872261183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist