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Individual

DR. CLYDE BRUCE SLAVIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
519 NW WILDWOOD DR, VANCOUVER, WA 98665-7545
(360) 909-3776
(360) 885-7989
Mailing address
519 NW WILDWOOD DR, VANCOUVER, WA 98665-7545
(360) 909-3776
(360) 885-7989

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
1212AT
OR
152W00000X
Optometrist
Primary
OD00001020
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2024354
WA
Enumeration date
04/13/2006
Last updated
01/27/2017
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