Individual
DR. CHARLES RONALD COVERDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
6830 NE BOTHELL WAY, SUITE B, KENMORE, WA 98028-3546
(425) 485-3051
(425) 482-2441
Mailing address
6830 NE BOTHELL WAY, SUITE B, KENMORE, WA 98028-3546
(425) 485-3051
(425) 482-2441
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
895
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
912126732
TAX ID
WA
Enumeration date
10/06/2006
Last updated
03/09/2010
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