Individual
DR. RODERICK BLAIR BEAZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
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
(717) 242-1915
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD60530417
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OD60530417
WASHINGTON DEPARTMENT OF HEALTH
WA
Enumeration date
07/07/2012
Last updated
10/28/2020
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