Provider Demographics
NPI:1629047360
Name:DEAN HATTAN OD
Entity Type:Organization
Organization Name:DEAN HATTAN OD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:H
Authorized Official - Last Name:HATTAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:509-758-0205
Mailing Address - Street 1:PO BOX 127
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:WA
Mailing Address - Zip Code:99403-0127
Mailing Address - Country:US
Mailing Address - Phone:509-758-0205
Mailing Address - Fax:509-751-0610
Practice Address - Street 1:301 5TH ST
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:WA
Practice Address - Zip Code:99403-1860
Practice Address - Country:US
Practice Address - Phone:509-758-0205
Practice Address - Fax:509-751-0610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-15
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty