Individual
CHARLES GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
939 CAROLINE ST, PORT ANGELES, WA 98362-3909
(360) 417-7315
Mailing address
5610 KITSAP WAY STE 320, BREMERTON, WA 98312-2266
(360) 792-2020
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CG61272324
WA
104100000X
Social Worker
Primary
SC61312299
WA
104100000X
Social Worker
SWI.LW.70000254
WA
1041C0700X
Clinical Social Worker
Primary
SWI.LW.70000254
WA
Other
Enumeration date
02/10/2022
Last updated
03/25/2026
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