Dale, Charles Robert
Dale, Charles Robert is an sole proprietor health care provider with primary practice located at 3002 Harborview Dr , Gig Harbor WA 98335-1962. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Dale, Charles Robert can be contacted via phone (253) 851-2050.Contact Information
Primary practice address
3002 Harborview Dr
Gig Harbor WA 98335-1962
Phone: (253) 851-2050
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Eye and Vision Services Providers / Optometrist | 152W00000X | 1642 | Washington |
Eye and Vision Services Providers / Optometrist | 152W00000X | 1758ATI | Oregon |
Eye and Vision Services Providers / Optometrist | 152W00000X | 169 | Wyoming |
Profile Details
NPI number | 1497801633 |
---|---|
LBN Legal business name | Dale, Charles Robert |
Credentials | Doctor of Optometry (OD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jan 27th, 2007 |
Last updated | Jul 9th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1497801633 | NPPES |
Washington | MEDICAID | 2004588 |
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