Organization
CHARLES A WARDLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DARCY DAVIS L.D.O. (OFFICE MANAGER)
(360) 423-7650
Entity
Organization
Contact information
Practice address
1426 COMMERCE AVE, LONGVIEW, WA 98632-3720
(360) 423-7650
(360) 423-2346
Mailing address
PO BOX 928, LONGVIEW, WA 98632-7582
(360) 423-7650
(360) 423-2346
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
907
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2046902
—
WA
01
—
DG6451
RAILROAD MEDICARE
WA
Enumeration date
11/27/2007
Last updated
09/23/2010
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