Chad Ryan Bouterse, DO - Medicare Ophthalmology in Clarkston, WA

Chad Ryan Bouterse, DO is a medicare enrolled "Ophthalmology" physician in Clarkston, Washington. He went to Michigan State University College Of Osteopathic Medicine and graduated in 2005 and has 19 years of diverse experience with area of expertise as Ophthalmology. He is a member of the group practice Eye Care Specialists Ps, Eye Care Specialists Ps and his current practice location is 500 Port Dr, Clarkston, Washington. You can reach out to his office (for appointments etc.) via phone at (509) 758-8811.

Chad Ryan Bouterse is licensed to practice in Washington (license number OP60127012) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1699896167.

Contact Information

Chad Ryan Bouterse, DO
500 Port Dr,
Clarkston, WA 99403-1835
(509) 758-8811
(509) 751-1188



Physician's Profile

Full NameChad Ryan Bouterse
GenderMale
SpecialityOphthalmology
Experience19 Years
Location500 Port Dr, Clarkston, Washington
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Chad Ryan Bouterse attended and graduated from Michigan State University College Of Osteopathic Medicine in 2005
  NPI Data:
  • NPI Number: 1699896167
  • Provider Enumeration Date: 04/03/2007
  • Last Update Date: 05/28/2010
  Medicare PECOS Information:
  • PECOS PAC ID: 0648321224
  • Enrollment ID: I20100225000087

Medical Identifiers

Medical identifiers for Chad Ryan Bouterse such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1699896167NPI-NPPES
0080BOOtherASURIS - CLARKSTON
1699896167OtherFEDERAL BLUE CROSS
808567101OtherIDMEDICAID - PULLMAN
258958OtherWAWASHINGTON LABOR & INDUSTRY
808567100OtherIDMEDICAID - CLARKSTON
1699896167OtherPREMERA BLUE CROSS
0081BOOtherASURIS - PULLMAN
O 0570OtherIDSTATE LICENSE
OP60127012OtherWASTATE LICENSE
1699896167OtherREGENCE BLUE SHIELD
1699896167OtherBLUE CROSS OF IDAHO
8564387MedicaidWA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207W00000XOphthalmology 5101016467 (Michigan)Secondary
207W00000XOphthalmology OP60127012 (Washington)Primary
207W00000XOphthalmology O 570 (Idaho)Secondary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Eye Care Specialists Ps37794737232
Eye Care Specialists Ps37794737232

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Medicare Reassignments

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Entity NameEye Care Specialists Ps
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1639160450
PECOS PAC ID: 3779473723
Enrollment ID: O20040317000302

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Medicare Part D Prescriber Enrollment

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Mailing Address and Practice Location

Mailing AddressPractice Location Address
Chad Ryan Bouterse, DO
500 Port Dr,
Clarkston, WA 99403-1835

Ph: (509) 758-8811
Chad Ryan Bouterse, DO
500 Port Dr,
Clarkston, WA 99403-1835

Ph: (509) 758-8811

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Ophthalmology Doctors in Clarkston, WA

Mark T Eggleston, MD
Ophthalmology
Medicare: Accepting Medicare Assignments
Practice Location: 500 Port Drive, Clarkston, WA 99403
Phone: 509-758-8811    Fax: 509-751-1188
Mr. Richard J Eggleston, MD
Ophthalmology
Medicare: Not Enrolled in Medicare
Practice Location: 500 Port Dr, Clarkston, WA 99403
Phone: 509-758-8811    Fax: 509-751-1188

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