Provider Demographics
NPI:1629527221
Name:CARDON, CHARNAE LEA (CNA)
Entity Type:Individual
Prefix:MRS
First Name:CHARNAE
Middle Name:LEA
Last Name:CARDON
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1642 SE 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-2209
Mailing Address - Country:US
Mailing Address - Phone:360-773-8582
Mailing Address - Fax:
Practice Address - Street 1:1642 SE 7TH AVE
Practice Address - Street 2:
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-2209
Practice Address - Country:US
Practice Address - Phone:360-773-8582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-25
Last Update Date:2016-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60390799376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide