Individual
DR. JOHN N CHESLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
950 11TH AVE, LONGVIEW, WA 98632-2504
(360) 577-1500
(360) 425-0735
Mailing address
950 11TH AVE, LONGVIEW, WA 98632-2504
(360) 577-1500
(360) 425-0735
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00003763
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0199625
LABOR & INDUSTRIES
WA
01
—
1610999
COMMUNITY HEALTH PLAN
WA
05
—
2027092
—
WA
01
—
7048CH
REGENCE BLUE CROSS
WA
Enumeration date
10/10/2006
Last updated
12/20/2007
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