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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497801633 NPPES
Washington MEDICAID 2004588

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