Provider Demographics
NPI:1861777914
Name:HORCH, CAMERON (OD)
Entity type:Individual
Prefix:
First Name:CAMERON
Middle Name:
Last Name:HORCH
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 1:101 NW 12TH AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BATTLE GROUND
Mailing Address - State:WA
Mailing Address - Zip Code:98604-9141
Mailing Address - Country:US
Mailing Address - Phone:360-687-0755
Mailing Address - Fax:
Practice Address - Street 1:101 NW 12TH AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:BATTLE GROUND
Practice Address - State:WA
Practice Address - Zip Code:98604-9141
Practice Address - Country:US
Practice Address - Phone:360-687-0755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD60485077152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8930953Medicare PIN