Provider Demographics
NPI:1396147542
Name:MORRIS, CHARLES JULES IV (PHARMD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:JULES
Last Name:MORRIS
Suffix:IV
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 TACOMA AVE S APT 702
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98402-2568
Mailing Address - Country:US
Mailing Address - Phone:423-580-7916
Mailing Address - Fax:
Practice Address - Street 1:220 TACOMA AVE S APT 702
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-2568
Practice Address - Country:US
Practice Address - Phone:423-580-7916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH 60491698183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist