- Medicare in Clarkston, WA

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is a medicare enrolled "Ophthalmology" provider in Clarkston, Washington. Their current practice location is 500 Port Dr, Clarkston, Washington. You can reach out to their office (for appointments etc.) via phone at (509) 758-8811.

is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1639160450.

Contact Information

500 Port Dr,
Clarkston, WA 99403-1835
(509) 758-8811
(509) 751-1188

Map and Direction




Healthcare Provider's Profile

Full Name
TypeFacility
SpecialityOphthalmology
Location500 Port Dr, Clarkston, Washington
Accepts Medicare AssignmentsMedicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1639160450
  • Provider Enumeration Date: 11/01/2005
  • Last Update Date: 04/30/2008
  Medicare PECOS Information:
  • PECOS PAC ID: 3779473723
  • Enrollment ID: O20040317000302

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1639160450NPI-NPPES
0123143OtherWALABOR & INDUSTRY
7088859MedicaidWA
8927759OtherWACRIME VICTIMS COMPENSATION ACT
BYHB9OtherIDBLUE CROSS OF IDAHO
000010006385OtherIDREGENCE BLUE SHIELD OF IDAHO
805350600MedicaidID
85977OtherIDBLUE CROSS OF IDAHO
QMXPR0064816OtherWAMOLINA HEALTHCARE
000010006387OtherFEDERAL BLUE CROSS

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
152W00000XOptometrist (* (Not Available))Secondary
207W00000XOphthalmology (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:
Provider NameChad R Bouterse
Provider TypePractitioner - Ophthalmology
Provider IdentifiersNPI Number: 1699896167
PECOS PAC ID: 0648321224
Enrollment ID: I20100225000087
Provider NameMark T Eggleston
Provider TypePractitioner - Ophthalmology
Provider IdentifiersNPI Number: 1306836705
PECOS PAC ID: 7416958293
Enrollment ID: I20100423000930

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address

500 Port Dr,
Clarkston, WA 99403-1835

Ph: (509) 758-8811
500 Port Dr,
Clarkston, WA 99403-1835

Ph: (509) 758-8811

Reviews and Comments



Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.