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Individual

DR. CHARLES PAUL DALY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
19020 33RD AVE W, SUITE 210, LYNNWOOD, WA 98036-4746
(425) 563-1500
(425) 563-1501
Mailing address
19020 33RD AVE W, SUITE 210, LYNNWOOD, WA 98036-4746
(425) 563-1500
(425) 563-1374

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
MD00030288
WA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
MD00030288
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
115847
L&I PROVIDER NUMBER
WA
01
155036
L&I PROVIDER NUMBER
WA
05
8159824
WA
Enumeration date
12/29/2005
Last updated
05/01/2018
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