Edmond, Charles V.

Edmond, Charles V. is an individual health care provider with primary practice located at 104 27Th Ave Se , Puyallup WA 98374-1145. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Otolaryngology, Allopathic & Osteopathic Physicians / Facial Plastic Surgery. Allopathic & Osteopathic Physicians / Otolaryngology is his primary health care specialty. Edmond, Charles V. can be contacted via phone (253) 770-9000.

Contact Information

Primary practice address
104 27Th Ave Se Puyallup WA 98374-1145
Fax: (253) 770-9712
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X MD30364 Washington
Allopathic & Osteopathic Physicians / Facial Plastic Surgery 207YS0123X MD00030364 Washington

Profile Details

NPI number 1851327324
LBN Legal business name Edmond, Charles V.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 24th, 2006
Last updated Oct 20th, 2015 - about 9 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 1851327324 NPPES
Washington MEDICAID 8145229

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