# MSO WASHINGTON, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Home Doctor
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891116109
- **Authorized official:** CHARLES PLUNKETT (PRESIDENT)
- **Authorized official phone:** (253) 984-7247

## Contact information

- **Practice address:** 4901 108TH ST SW, LAKEWOOD, WA 98499-3724
- **Practice address phone:** (253) 984-7247
- **Practice address fax:** (253) 584-8916
- **Mailing address:** PO BOX 98886, LAKEWOOD, WA 98496-8886
- **Mailing address phone:** (253) 984-7247
- **Mailing address fax:** (253) 584-8916

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 01/04/2014
- **Last updated:** 10/27/2020