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Individual

JOHN P RUNDLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3200 MAIN STREET, VANCOUVER, WA 98663
(360) 696-4691
(360) 823-2260
Mailing address
PO BOX 61896, VANCOUVER, WA 98666-1896
(360) 823-2012
(360) 823-2260

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD00010095
WA
207W00000X
Ophthalmology Physician
MD06391
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8196701
WA
Enumeration date
02/17/2006
Last updated
01/02/2019
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