Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
CHAD RYAN BOUTERSE, D.O.
ActiveOphthalmology · CLARKSTON, WA
Registration Details
- NPI Number
- 1699896167
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 3, 2007 (19.067714611991 yrs)
- Last Updated
- May 28, 2010
- Licenses
-
5101016467 (MI)OP60127012 (WA)O 570 (ID)
Practice Information
- Address
-
500 PORT DRCLARKSTON, WA, 994031835Browse WA providers · Browse ZIP 99403
- Phone
- 5097588811
- Fax
- 5097511188
- Primary Specialty
-
Ophthalmology
207W00000X
- Additional Specialty
- Ophthalmology
- Additional Specialty
- Ophthalmology
Other Ophthalmology Providers in CLARKSTON, WA
| Name | Credential | NPI |
|---|---|---|
| MARK T EGGLESTON | MD | 1306836705 |
| MR. RICHARD J EGGLESTON | MD | 1821088147 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.