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Charles J Davis, PA-C
Medical Physician Assistant in Renton, Washington
NPI 1962422956

Charles J Davis is a Medical Physician Assistant based in Renton, WA and is specialized in Medical. Charles J Davis practices in Renton, WA and has the professional credentials of PA-C. The NPI Number for Charles J Davis is 1962422956 and holds a License No. PA10004461 (Washington).

The current practice location address for Charles J Davis is 14410 Se Petrovitsky Rd Ste 104, Renton, WA and can be reached out via phone at 425-690-3405 and via fax at 425-690-9405. You can also correspond with Charles J Davis through the mailing address at 3600 LIND AVE SW, RENTON, WA - 98057-4970 (mailing address contact number: 425-690-2715).

Location: 14410 Se Petrovitsky Rd Ste 104, Renton, WA, 98057-4970
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Provider Profile Details
NPI Number
1962422956
Provider Name
Charles J Davis
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
14410 Se Petrovitsky Rd Ste 104, Renton, WA, 98057-4970
Phone Number
425-690-3405
Fax Number
425-690-9405
Provider Enumeration Date
07/20/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
G8971468 01 WA MEDICARE W VALLEY MEDICAL GROUP - RENTON
1023188 05 WA
institution
Provider Business Practice Location Address Details
Address
14410 Se Petrovitsky Rd Ste 104
City
State
Zip
98058-8900
Phone Number
425-690-3405
Fax Number
425-690-9405
person
Provider Business Mailing Address Details
Address
3600 Lind Ave Sw
City
State
Zip
98057-4970
Phone Number
425-690-2715
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA10004461 (Washington)
Definition
Definition to come...
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