Dr Charles E Wang, MD | |
222 15th Ave Se, Puyallup, WA 98372-3754 | |
(253) 841-4353 | |
(253) 581-5698 |
Full Name | Dr Charles E Wang |
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Gender | Male |
Speciality | Radiology - Diagnostic Radiology |
Location | 222 15th Ave Se, Puyallup, Washington |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1063476984 | NPI | - | NPPES |
8391054 | Medicaid | WA | |
185865 | Other | WA | L&I |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2085R0202X | Radiology - Diagnostic Radiology | MD00043610 (Washington) | Primary |
2085R0202X | Radiology - Diagnostic Radiology | ME85716 (Florida) | Secondary |
Entity Name | Kaiser Foundation Health Plan Of The Northwest |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1184786527 PECOS PAC ID: 5799688230 Enrollment ID: O20040220000099 |
Mailing Address | Practice Location Address |
---|---|
Dr Charles E Wang, MD 7424 Bridgeport Way W, Suite 103, Lakewood, WA 98499-8120 Ph: (253) 841-4353 | Dr Charles E Wang, MD 222 15th Ave Se, Puyallup, WA 98372-3754 Ph: (253) 841-4353 |
Dr. Clare Zeno Andersen, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 222 15th Ave Se, Puyallup, WA 98372 Phone: 253-841-4353 Fax: 253-581-5698 | |
Dr. Alison Jean Reinbold, M.D. Radiology Medicare: Medicare Enrolled Practice Location: 222 15th Ave Se, Puyallup, WA 98372 Phone: 253-841-4353 Fax: 253-581-5698 | |
Londe Apolphe Richardson, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 222 15th Ave Se, Puyallup, WA 98372 Phone: 253-841-4353 Fax: 253-581-5698 | |
Dr. Katherine Ann Choi-chinn, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 222 15th Ave Se, Puyallup, WA 98372 Phone: 253-841-4353 Fax: 253-581-5698 | |
Dr. Alan David Pearson, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 222 15th Ave Se, Puyallup, WA 98372 Phone: 253-841-4353 Fax: 253-581-5698 | |
Dr. Raymond Joel Pliskow, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 222 15th Ave Se, Puyallup, WA 98372 Phone: 253-841-4353 Fax: 253-581-5698 |