Individual
CHARLES M PIATOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1717 S J ST, TACOMA, WA 98405-4933
(844) 364-2778
(253) 215-1096
Mailing address
1717 S J ST, TACOMA, WA 98405-4933
(844) 364-2778
(253) 215-1096
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD00031358
WA
207L00000X
Anesthesiology Physician
MD31358
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0236638
STATE L&I
WA
05
—
1012969
—
WA
05
—
8178673
—
WA
Enumeration date
11/02/2005
Last updated
12/08/2020
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