Individual
CHARLES WYNKOOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
105 N W 1ST STREET, COUPEVILLE, WA 98239
(360) 678-5555
Mailing address
1370 NW FALLS CREEK LOOP, APT. 102, OAK HARBOR, WA 98277-3835
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CG60251516
WA
Other
Enumeration date
11/07/2011
Last updated
11/07/2011
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