Organization
GRAYS HARBOR VISION CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRAIG D. MEHLHOFF O. D. (DR./PRESIDENT)
(360) 533-1880
Entity
Organization
Contact information
Practice address
301 N BROADWAY ST, ABERDEEN, WA 98520-3933
(360) 533-1880
(360) 533-1886
Mailing address
PO BOX 388, ABERDEEN, WA 98520-0093
(360) 533-1880
(360) 533-1886
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
601 803 571
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1006392
—
WA
01
—
135989135989
BLUE CROSS PROV. #
WA
Enumeration date
10/13/2006
Last updated
05/20/2010
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