Individual
DR. JOHN C STODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1179 S MARKET BLVD, CHEHALIS, WA 98532-3427
(360) 748-9228
(360) 748-4617
Mailing address
PO BOX 1126, CHEHALIS, WA 98532-0169
(360) 748-9228
(360) 748-4617
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00001851
WA
152WP0200X
Pediatric Optometrist
OD00001851
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0036580
L&I CLINIC GROUP
WA
01
—
0056033
L&I JCSTODDARD ONLY
WA
05
—
2011716
—
WA
05
—
2046506
—
WA
01
—
HE7836
REGENCE CLINIC NUMBER
WA
01
—
ST3361
REGENCE JCSTODDARD
WA
Enumeration date
09/21/2006
Last updated
01/03/2013
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