Individual
DR. CHARLES E WANG
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
222 15TH AVE SE, PUYALLUP, WA 98372-3754
(253) 841-4353
(253) 581-5698
Mailing address
7424 BRIDGEPORT WAY W, SUITE 103, LAKEWOOD, WA 98499-8120
(253) 841-4353
(253) 581-5698
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD00043610
WA
2085R0202X
Diagnostic Radiology Physician
ME85716
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
185865
L&I
WA
05
—
8391054
—
WA
Enumeration date
04/17/2006
Last updated
07/08/2007
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