Individual
DR. RANDALL J. MCCLELLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
14406 NE 20TH AVE, VANCOUVER, WA 98686-1448
(360) 571-3084
(360) 571-3082
Mailing address
14406 NE 20TH AVE, VANCOUVER, WA 98686-1448
(360) 571-3084
(360) 571-3082
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3180AT
OR
152WP0200X
Pediatric Optometrist
3180AT
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
240203
—
OR
Enumeration date
08/08/2006
Last updated
06/08/2015
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