Slavin, Clyde Bruce
Slavin, Clyde Bruce is an individual health care provider with primary practice located at 519 Nw Wildwood Dr , Vancouver WA 98665-7545. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Slavin, Clyde Bruce can be contacted via phone (360) 909-3776.Contact Information
Primary practice address
519 Nw Wildwood Dr
Vancouver WA 98665-7545
Phone: (360) 909-3776
Fax: (360) 885-7989
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OD00001020 | Washington |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1212AT | Oregon |
Profile Details
| NPI number | 1780648055 |
|---|---|
| LBN Legal business name | Slavin, Clyde Bruce |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 13th, 2006 |
| Last updated | Jan 27th, 2017 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780648055 | NPPES |
| Washington | MEDICAID | 2024354 |
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