Chad Ryan Bouterse, DO | |
500 Port Dr, Clarkston, WA 99403-1835 | |
(509) 758-8811 | |
(509) 751-1188 |
Full Name | Chad Ryan Bouterse |
---|---|
Gender | Male |
Speciality | Ophthalmology |
Experience | 19 Years |
Location | 500 Port Dr, Clarkston, Washington |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1699896167 | NPI | - | NPPES |
0080BO | Other | ASURIS - CLARKSTON | |
1699896167 | Other | FEDERAL BLUE CROSS | |
808567101 | Other | ID | MEDICAID - PULLMAN |
258958 | Other | WA | WASHINGTON LABOR & INDUSTRY |
808567100 | Other | ID | MEDICAID - CLARKSTON |
1699896167 | Other | PREMERA BLUE CROSS | |
0081BO | Other | ASURIS - PULLMAN | |
O 0570 | Other | ID | STATE LICENSE |
OP60127012 | Other | WA | STATE LICENSE |
1699896167 | Other | REGENCE BLUE SHIELD | |
1699896167 | Other | BLUE CROSS OF IDAHO | |
8564387 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207W00000X | Ophthalmology | 5101016467 (Michigan) | Secondary |
207W00000X | Ophthalmology | OP60127012 (Washington) | Primary |
207W00000X | Ophthalmology | O 570 (Idaho) | Secondary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Eye Care Specialists Ps | 3779473723 | 2 |
Eye Care Specialists Ps | 3779473723 | 2 |
Entity Name | Eye Care Specialists Ps |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1639160450 PECOS PAC ID: 3779473723 Enrollment ID: O20040317000302 |
Mailing Address | Practice Location Address |
---|---|
Chad Ryan Bouterse, DO 500 Port Dr, Clarkston, WA 99403-1835 Ph: (509) 758-8811 | Chad Ryan Bouterse, DO 500 Port Dr, Clarkston, WA 99403-1835 Ph: (509) 758-8811 |
Mark T Eggleston, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 500 Port Drive, Clarkston, WA 99403 Phone: 509-758-8811 Fax: 509-751-1188 | |
Mr. Richard J Eggleston, MD Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 500 Port Dr, Clarkston, WA 99403 Phone: 509-758-8811 Fax: 509-751-1188 |