Individual
DR. ROGER M BLAUVELT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
122 3RD ST NE, AUBURN, WA 98002-4013
(253) 833-7750
(253) 833-7469
Mailing address
122 3RD ST NE, AUBURN, WA 98002-4013
(253) 833-7750
(253) 887-9804
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD00034945
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1101260
DSHS
WA
05
—
1101260
—
WA
01
—
172908
LABOR & INDUSTRIES
WA
01
—
5677BL
REGENCE
WA
01
—
GAB38443
MEDICARE LEGACY
WA
Enumeration date
01/05/2006
Last updated
02/14/2020
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