Individual provider Active NPI

Charles C Watras, LCAS

  • Social Worker
  • Bellingham, WA
National Provider Identifier
1265785695
Registry record updated Mar 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LW60530862 Issued in WA
Practice address
3350 Airport Dr
Bellingham, WA 98226-7696
Phone
(360) 734-5458
Fax
(360) 734-5298
NPI assigned
Oct 23, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LW60530862 WA Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X CP60544158 WA

Addresses

Primary practice location

3350 Airport Dr
Bellingham, WA 98226-7696

Mailing address

PO Box 34703
Seattle, WA 98124-1703
Phone (206) 764-3335

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP60544158WAMDAddiction (Substance Use Disorder) Counselor
LW60530862WAMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1350950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459382400000",
    "number": "1265785695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703",
            "telephone_number": "206-764-3335",
            "fax_number": "206-764-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 AIRPORT DR",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982267696",
            "telephone_number": "360-734-5458",
            "fax_number": "360-734-5298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATRAS",
        "first_name": "CHARLES",
        "middle_name": "C",
        "credential": "LCAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-23",
        "last_updated": "2016-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "LW60530862",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60544158",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.