Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Charles Ibeziako, MD

Individual provider Family Medicine Physician · NPI 1093695249

Charles Ibeziako, MD is a Family Practice in Othello, Washington. Qualified in 1994, 32 years ago. Practices with Columbia Basin Health Association, a 43-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
32
Licensed in
WA
In the registry since
2025
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1515 E Columbia St
Othello, WA 99344-1846
Phone: (509) 488-5256
Fax: (509) 488-9939
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 601 Government Rd, Mattawa, WA 99349-5120 — (509) 488-5256

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence ML70050698 (WA)

Record details

NPI number1093695249
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedSeptember 6, 2025
Last updated in NPPESSeptember 23, 2025
Certification dateSeptember 23, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 1994 (32 years in practice)
Group practice Columbia Basin Health Association — 43 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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