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Individual

DR. JOHN N CHESLOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

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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