Provider Demographics
NPI:1578639480
Name:POWER, CHARLES WESLEY (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:WESLEY
Last Name:POWER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:22180 OLYMPIC COLLEGE WAY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-6664
Mailing Address - Country:US
Mailing Address - Phone:360-394-3500
Mailing Address - Fax:360-394-3501
Practice Address - Street 1:22180 OLYMPIC COLLEGE WAY
Practice Address - Street 2:SUITE 201
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-6664
Practice Address - Country:US
Practice Address - Phone:360-394-3500
Practice Address - Fax:360-394-3501
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00026418207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1180033Medicaid
WA080131740OtherRAILROAD MEDICARE
WA1180033Medicaid
WAD24640Medicare UPIN