Mcclellan, Randall J.
Mcclellan, Randall J. is an individual health care provider with primary practice located at 14406 Ne 20Th Ave , Vancouver WA 98686-1448. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Pediatrics. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Mcclellan, Randall J. can be contacted via phone (360) 571-3084.Contact Information
Primary practice address
14406 Ne 20Th Ave
Vancouver WA 98686-1448
Phone: (360) 571-3084
Fax: (360) 571-3082
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 3180AT | Oregon |
| Eye and Vision Services Providers / Pediatrics | 152WP0200X | 3180AT | Oregon |
Profile Details
| NPI number | 1215947932 |
|---|---|
| LBN Legal business name | Mcclellan, Randall J. |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 8th, 2006 |
| Last updated | Jun 8th, 2015 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215947932 | NPPES |
| Oregon | MEDICAID | 240203 |
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