Provider Demographics
NPI:1407043235
Name:SCHOTT, CHARLES WESLEY III (FNP)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:WESLEY
Last Name:SCHOTT
Suffix:III
Gender:M
Credentials:FNP
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Mailing Address - Street 1:9481 OAK BAY RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:PORT LUDLOW
Mailing Address - State:WA
Mailing Address - Zip Code:98365-9794
Mailing Address - Country:US
Mailing Address - Phone:360-437-5067
Mailing Address - Fax:360-437-4158
Practice Address - Street 1:9481 OAK BAY RD
Practice Address - Street 2:SUITE A
Practice Address - City:PORT LUDLOW
Practice Address - State:WA
Practice Address - Zip Code:98365-9794
Practice Address - Country:US
Practice Address - Phone:360-437-5067
Practice Address - Fax:360-437-4158
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAAP60216750363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily