Provider Demographics
NPI:1396890653
Name:RANCE, CHARLES WILLIAM (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:WILLIAM
Last Name:RANCE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1901 S UNION AVE STE A211
Mailing Address - Street 2:ALLENMORE MEDICAL CENTER
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1709
Mailing Address - Country:US
Mailing Address - Phone:253-627-2331
Mailing Address - Fax:253-305-0509
Practice Address - Street 1:1901 S UNION AVE STE A211
Practice Address - Street 2:ALLENMORE MEDICAL CENTER
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1709
Practice Address - Country:US
Practice Address - Phone:253-627-2331
Practice Address - Fax:253-305-0509
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
WAMD00016502207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1354802Medicaid
WAA08576Medicare UPIN