Provider Demographics
NPI:1861545691
Name:SAXBY, CHARLOTTE P (MD)
Entity type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:P
Last Name:SAXBY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 34581
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1581
Mailing Address - Country:US
Mailing Address - Phone:509-241-7349
Mailing Address - Fax:509-241-7628
Practice Address - Street 1:2930 MAPLE ST
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3832
Practice Address - Country:US
Practice Address - Phone:425-261-1500
Practice Address - Fax:425-261-1830
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00030320207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA233720OtherL&I
WA8146466Medicaid
WAGAB23810Medicare PIN
WAG000166356Medicare PIN
WAF27428Medicare UPIN
WAGAB23813Medicare PIN
WAP00151839Medicare PIN
WA8146466Medicaid
G8872704Medicare PIN
WA233720OtherL&I