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Chad Ryan Bouterse, DO
Ophthalmology Physician in Clarkston, Washington
NPI 1699896167

Chad Ryan Bouterse is a Ophthalmology Physician based in Clarkston, WA. Chad Ryan Bouterse practices in Clarkston, WA and has the professional credentials of DO. The NPI Number for Chad Ryan Bouterse is 1699896167 and holds a License No. 5101016467 (Washington).

The current practice location address for Chad Ryan Bouterse is 500 Port Dr, Clarkston, WA and can be reached out via phone at 509-758-8811 and via fax at 509-751-1188.

Location: 500 Port Dr, Clarkston, WA, 99403-1835
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1699896167
Provider Name
Chad Ryan Bouterse
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
500 Port Dr, Clarkston, WA, 99403-1835
Phone Number
509-758-8811
Fax Number
509-751-1188
Provider Enumeration Date
04/03/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0080BO 01 ASURIS - CLARKSTON
1699896167 01 FEDERAL BLUE CROSS
808567101 01 ID MEDICAID - PULLMAN
258958 01 WA WASHINGTON LABOR & INDUSTRY
808567100 01 ID MEDICAID - CLARKSTON
1699896167 01 PREMERA BLUE CROSS
0081BO 01 ASURIS - PULLMAN
O 0570 01 ID STATE LICENSE
OP60127012 01 WA STATE LICENSE
1699896167 01 REGENCE BLUE SHIELD
1699896167 01 BLUE CROSS OF IDAHO
8564387 05 WA
institution
Provider Business Practice Location Address Details
Address
500 Port Dr
City
Clarkston
State
Washington
Zip
99403-1835
Phone Number
509-758-8811
Fax Number
509-751-1188
person
Provider Business Mailing Address Details
Address
500 Port Dr
City
Clarkston
State
Washington
Zip
99403-1835
Phone Number
509-758-8811
Fax Number
509-751-1188
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Ophthalmology
Speciality
-
Taxonomy
207W00000X
License No.
5101016467 (Michigan)
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
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