| Mrs Pamela Dae Dick, MS, RD, CDCES | |
|
100 Hospital Dr, Ste 111, Ketchum, ID 83340 | |
| (208) 727-8356 | |
| (208) 727-8357 |
| Full Name | Mrs Pamela Dae Dick |
|---|---|
| Gender | Female |
| Speciality | Registered Dietitian Or Nutrition Professional |
| Experience | 5 Years |
| Location | 100 Hospital Dr, Ketchum, Idaho |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598947368 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | DI00001224 (Washington) | Secondary |
| 133V00000X | Dietitian, Registered | 3971987 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Samaritan Hospital | Moses lake, WA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Grant County Public Hospital District 1 | 9931095692 | 81 |
| Provider Name | Grant County Public Hospital District 1 |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1619086766 PECOS PAC ID: 9931095692 Enrollment ID: O20040227000602 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Pamela Dae Dick, MS, RD, CDCES 190 E Bannock St, Boise, ID 83712-6241 Ph: () - | Mrs Pamela Dae Dick, MS, RD, CDCES 100 Hospital Dr, Ste 111, Ketchum, ID 83340 Ph: (208) 727-8356 |
Sarah Barnett Seppa, RD, LD, CDE Dietitian Medicare: Not Enrolled in Medicare Practice Location: 100 Hospital Drive, Ketchum, ID 83340 Phone: 208-727-8356 Fax: 208-727-8357 | |
Mariah Elise Stout, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 100 Hospital Dr., Ketchum, ID 83340 Phone: 208-727-8356 | |
Teresa Brennan, R.D. Dietitian Medicare: Accepting Medicare Assignments Practice Location: 100 Hospital Dr, Ketchum, ID 83340 Phone: 208-727-8800 |