Organization
CASCADE FAMILY EYE CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RODERICK BLAIR BEAZER OD (OWNER)
(801) 623-1390
Entity
Organization
Contact information
Practice address
9623 32ND ST SE STE D121, LAKE STEVENS, WA 98258-5780
(425) 377-9747
(425) 377-8757
Mailing address
9623 32ND ST SE STE D121, LAKE STEVENS, WA 98258-5780
(425) 377-9747
(425) 377-8757
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2085
WA
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1024797
MEDICAID DOMAIN #
WA
05
—
2031821
—
WA
Enumeration date
06/30/2006
Last updated
10/28/2020
Update your record
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