Willis, Charla Rae

Willis, Charla Rae is an individual health care provider with primary practice located at 2315 8Th St , Lewiston ID 83501-7301. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Willis, Charla Rae can be contacted via phone (208) 746-1383.

Contact Information

Primary practice address
2315 8Th St Lewiston ID 83501-7301
Phone: (208) 746-1383
Fax: (208) 746-6348
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X M9369 Idaho
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD00045264 Washington
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 033594 Connecticut
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X D0056472 Maryland

Profile Details

NPI number 1497846091
LBN Legal business name Willis, Charla Rae
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 27th, 2006
Last updated Mar 7th, 2016 - about 8 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 1497846091 NPPES
Washington MEDICAID 1011897
Washington Other 74930
Washington Other 1131387
Washington Other 0222531
Washington Other 1497846091
Washington MEDICAID 1497846091

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