Provider Demographics
NPI:1639182116
Name:ARDELEANU, VALENTIN (OD)
Entity Type:Individual
Prefix:
First Name:VALENTIN
Middle Name:
Last Name:ARDELEANU
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12607 SE MILL PLAIN BLVD.
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-4098
Mailing Address - Country:US
Mailing Address - Phone:360-896-4456
Mailing Address - Fax:360-896-4457
Practice Address - Street 1:12607 SE MILL PLAIN BLVD.
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-4098
Practice Address - Country:US
Practice Address - Phone:360-896-4456
Practice Address - Fax:360-896-4457
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3068ATI152W00000X
WAOD00003135152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist