Individual
CHARLES Q MA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1330 ROCKEFELLER AVE STE 400, EVERETT, WA 98201-1676
(425) 261-4950
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
(866) 747-2455
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
293338
NY
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD61452148
WA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
ME148920
FL
390200000X
Student in an Organized Health Care Education/Training Program
293338
NY
Other
Enumeration date
04/20/2013
Last updated
08/21/2023
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