Individual
CHARLIE L PHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
751 NE BLAKELY DR STE 4020, ISSAQUAH, WA 98029-6201
(425) 313-4000
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
TA60888612
WA
363AS0400X
Surgical Physician Assistant
Primary
PA60882779
WA
Other
Enumeration date
01/23/2018
Last updated
10/16/2018
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