Provider Demographics
NPI:1013952738
Name:ALDERMAN, CHARENE S (ARNP)
Entity Type:Individual
Prefix:
First Name:CHARENE
Middle Name:S
Last Name:ALDERMAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:CHARENE
Other - Middle Name:MERI
Other - Last Name:ALDERMAN OR ALDERMAN-MCELROY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 850
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362-0146
Mailing Address - Country:US
Mailing Address - Phone:360-683-9895
Mailing Address - Fax:360-582-5614
Practice Address - Street 1:844 N 5TH AVE
Practice Address - Street 2:
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-3045
Practice Address - Country:US
Practice Address - Phone:360-683-9895
Practice Address - Fax:360-582-5614
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00071607163W00000X
WAAP30003966363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0225163OtherLABOR AND INDUSTRIESL
WA8869722Medicare PIN