Individual
MS. CHARLENE MARIE WALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
2501 N 45TH ST, SEATTLE, WA 98103-6909
(206) 526-5222
(206) 675-1460
Mailing address
2501 N 45TH ST, SEATTLE, WA 98103-6909
(206) 526-5222
(206) 675-1460
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD60558068
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G8942686
MEDICARE PTAN
WA
Enumeration date
10/10/2012
Last updated
12/01/2021
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