Provider Demographics
NPI:1932451796
Name:HOUCHIN, CHARLES R (PA-C)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:R
Last Name:HOUCHIN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 W BOONE AVE
Mailing Address - Street 2:SUITE 757
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-2354
Mailing Address - Country:US
Mailing Address - Phone:509-868-0876
Mailing Address - Fax:509-385-0670
Practice Address - Street 1:316 W BOONE AVE
Practice Address - Street 2:SUITE 757
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2354
Practice Address - Country:US
Practice Address - Phone:509-868-0876
Practice Address - Fax:509-385-0670
Is Sole Proprietor?:No
Enumeration Date:2012-10-03
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAPA60315277363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant