| |
207 S Chehalis St, Aberdeen, WA 98520-2945 | |
(360) 533-2020 | |
(360) 533-1978 |
Full Name | |
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Type | Facility |
Speciality | Ophthalmology |
Location | 207 S Chehalis St, Aberdeen, Washington |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1962690701 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | OD60310191 (Washington) | Secondary |
207W00000X | Ophthalmology | MD28344 (Washington) | Primary |
Provider Name | Susan Ruyle |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1215969878 PECOS PAC ID: 2163415027 Enrollment ID: I20040513000485 |
Provider Name | Joshua Douglas Pratt |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1457621856 PECOS PAC ID: 8022271543 Enrollment ID: I20130205000503 |
Mailing Address | Practice Location Address |
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207 S Chehalis St, Aberdeen, WA 98520-2945 Ph: (360) 533-2020 | 207 S Chehalis St, Aberdeen, WA 98520-2945 Ph: (360) 533-2020 |