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Contact Information

CHARLES A WARDLE
1426 COMMERCE AVE
LONGVIEW, WA98632-3720
 Phone: 360-423-7650
 Fax: 360-423-2346
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for CHARLES A WARDLE

NPI # 1154503605
LBN Legal business name CHARLES A WARDLE
Authorized official DARCY DAVIS - (OFFICE MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 11/27/2007
Last updated 09/23/2010 - About 16 years ago
Identifiers
WA License # 907
WA Medicaid 2046902
WA Other DG6451 RAILROAD MEDICARE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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