Individual
TODD J CHARLESWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
2901 SQUALICUM PKWY, BELLINGHAM, WA 98225-1851
(360) 738-6765
(360) 738-6377
Mailing address
1 BOONE RD, BREMERTON, WA 98312-1894
(425) 304-4160
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10005145
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0218367
LIWA
WA
01
—
5357CH
BSWA
WA
05
—
8474355
—
WA
Enumeration date
09/06/2006
Last updated
09/26/2011
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