Individual
DR. CHARLES K MINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1708 YAKIMA AVE, STE 107, TACOMA, WA 98405-5307
(253) 272-5881
(253) 383-0161
Mailing address
1708 YAKIMA AVE, STE 107, TACOMA, WA 98405-5307
(253) 272-5881
(253) 383-0161
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
P7514
TX
207RN0300X
Nephrology Physician
Primary
MD60566032
WA
207RN0300X
Nephrology Physician
P7514
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
349638
STATE L&I
WA
Enumeration date
10/25/2012
Last updated
10/25/2022
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