Provider Demographics
NPI:1598877169
Name:REED, CHARLES S (RPH)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:S
Last Name:REED
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 316
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98233-0316
Mailing Address - Country:US
Mailing Address - Phone:360-755-0441
Mailing Address - Fax:360-755-0627
Practice Address - Street 1:130 E FAIRHAVEN AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98233-1740
Practice Address - Country:US
Practice Address - Phone:360-755-0441
Practice Address - Fax:360-755-0627
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00010775183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist