Charles Edward Carlson, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

PH00021028 Issued in WA

Practice address

11 S Forks Ave
Forks, WA 98331-9006

Phone

(360) 374-2294

Fax

(360) 374-5057

NPI assigned

Nov 13, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Chinook Pharmacy Clinical

  dba Chinook Pharmacy INC.

  • Family Medicine Physician
  • Forks, WA
  • NPI 1417528282
  Authorized official Same address or phone

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356412134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 VALLEY VIEW DR",
            "city": "FORKS",
            "state": "WA",
            "postal_code": "983319600",
            "telephone_number": "360-374-2434",
            "fax_number": "360-374-5057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 S FORKS AVE",
            "city": "FORKS",
            "state": "WA",
            "postal_code": "983319006",
            "telephone_number": "360-374-2294",
            "fax_number": "360-374-5057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "CHARLES",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00021028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla N Boyle
• Kelsey Lynn Breedlove
• Bradley Myron Brown
• Heather Dawn Brux
• Elizabeth Cadwell
• Amber Telisa Carmody
• Jeffery Lejay Chen, MD
• Chinook Pharmacy Clinical (Chinook Pharmacy INC.)
• Chinook Pharmacy Inc (Chinook Pharmacy LTC)
• Chinook Pharmacy Inc (Chinook Pharmacy)

• Pharmacist in Forks, WA
• Providers in Forks, WA by specialty
• Pharmacist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.