Individual
CHARLES M WEATHERBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1812 S J ST STE 102, TACOMA, WA 98405-4965
(253) 552-4900
(253) 627-1886
Mailing address
1145 BROADWAY FL 2, SEATTLE, WA 98122-4201
(206) 860-5414
(206) 720-8462
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00019117
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022508
—
WA
Enumeration date
02/09/2006
Last updated
04/16/2021
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