Active NPI
Derald Charles, MD
- Forensic Pathology Physician
- Tacoma, WA
National Provider Identifier
1588126759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Pathology Physician
- License
- MD61622864
- Practice address
- 3619 Pacific Ave
Tacoma, WA 98418-7929 - Phone
- (253) 798-6494
- Fax
- (253) 798-2893
- NPI assigned
- Apr 4, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Forensic Pathology Physician | 207ZF0201X | MD61622864 | WA | Primary |
Addresses
Primary practice location
3619 Pacific Ave
Tacoma, WA 98418-7929
Mailing address
3619 Pacific Ave
Tacoma, WA 98418-7921
Phone (253) 798-6494
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD61622864 | WA | MD | Forensic Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746489600000",
"number": "1588126759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3619 PACIFIC AVE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984187921",
"telephone_number": "253-798-6494",
"fax_number": "253-798-2893"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3619 PACIFIC AVE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984187929",
"telephone_number": "253-798-6494",
"fax_number": "253-798-2893"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHARLES",
"first_name": "DERALD",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-04",
"last_updated": "2025-05-06",
"certification_date": "2025-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "207ZF0201X",
"taxonomy_group": "",
"desc": "Pathology, Forensic Pathology",
"state": "WA",
"license": "MD61622864",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.