Chad Ryan Bouterse, D.O.
Ophthalmology in Clarkston, WA. Individual provider (NPI-1).
NPI number1699896167
StatusActive
Last updated in NPPESMay 28, 2010
Details
- NPI
- 1699896167
- Entity type
- Individual (NPI-1)
- Name
- Chad Ryan Bouterse
- Credential
- D.O.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 3, 2007
- Last updated
- May 28, 2010
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - OPHTHALMOLOGY
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207W00000X | Ophthalmology | OP60127012 | WA | Yes |
| 207W00000X | Ophthalmology | 5101016467 | MI | |
| 207W00000X | Ophthalmology | O 570 | ID |
Practice location
500 Port DrClarkston, WA 99403-1835
Phone 509-758-8811 · Fax 509-751-1188
Mailing address
500 Port DrClarkston, WA 99403-1835
Phone 509-758-8811 · Fax 509-751-1188
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Ophthalmology Physician providers in Clarkston, WA
- Mark T Eggleston, MDNPI 1306836705
- Richard J Eggleston, MDNPI 1821088147
- Eye Care Specialists PsNPI 1639160450
- Eye Care Specialists PsNPI 1972514917
- W Richard Herbert MD PsNPI 1760632004
All 6 Ophthalmology Physician providers in Clarkston · All 526 providers in Clarkston
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