Individual
CHARLES D WHELAN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3015 SQUALICUM PKWY, BELLINGHAM, WA 98225-1945
(360) 733-2092
(360) 733-4013
Mailing address
1115 SE 164TH AVE, DEPT 358, VANCOUVER, WA 98683-9324
(360) 733-2092
(360) 733-4013
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10005113
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0111WH
REGENCE
WA
01
—
0266104
L&I AND CRIME VICTIMS
WA
05
—
1922165026
—
WA
Enumeration date
01/02/2007
Last updated
11/18/2014
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