Bouterse, Chad Ryan

Bouterse, Chad Ryan is an individual health care provider with primary practice located at 500 Port Dr , Clarkston WA 99403-1835. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Bouterse, Chad Ryan can be contacted via phone (509) 758-8811.

Contact Information

Primary practice address
500 Port Dr Clarkston WA 99403-1835
Phone: (509) 758-8811
Fax: (509) 751-1188
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 5101016467 Michigan
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X OP60127012 Washington
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X O 570 Idaho

Profile Details

NPI number 1699896167
LBN Legal business name Bouterse, Chad Ryan
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 3rd, 2007
Last updated May 28th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699896167 NPPES
Other 0080BO ASURIS - CLARKSTON
Other 1699896167 ASURIS - CLARKSTON
Other 808567101 ASURIS - CLARKSTON
Other 258958 ASURIS - CLARKSTON
Other 808567100 ASURIS - CLARKSTON
Other 1699896167 ASURIS - CLARKSTON
Other 0081BO ASURIS - CLARKSTON
Other O 0570 ASURIS - CLARKSTON
Other OP60127012 ASURIS - CLARKSTON
Other 1699896167 ASURIS - CLARKSTON
Other 1699896167 ASURIS - CLARKSTON
MEDICAID 8564387 ASURIS - CLARKSTON

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