Individual
MR. CHARLES TIFFANY BARRET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C.
Contact information
Practice address
90 SE KLAH CHE MIN DR, SHELTON, WA 98584-9216
(360) 427-9006
(360) 427-1951
Mailing address
3040 LILLY RD NE, OLYMPIA, WA 98506-3007
(360) 491-7917
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10000621
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8601197
—
WA
Enumeration date
03/19/2007
Last updated
07/08/2007
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