Organization
LEWIS COUNTY EYE & VISION, INC., P.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN C STODDARD O.D. (CEO)
(360) 748-9228
Entity
Organization
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
152WP0200X
Pediatric Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0036580
L&I
WA
05
—
2046506
—
WA
01
—
HE7836
REGENCE
WA
Enumeration date
09/21/2006
Last updated
05/16/2008
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