Blauvelt, Roger M

Blauvelt, Roger M is an individual health care provider with primary practice located at 122 3Rd St Ne , Auburn WA 98002-4013. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Blauvelt, Roger M can be contacted via phone (253) 833-7750.

Contact Information

Primary practice address
122 3Rd St Ne Auburn WA 98002-4013
Phone: (253) 833-7750
Fax: (253) 833-7469
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X MD00034945 Washington

Profile Details

NPI number 1932187341
LBN Legal business name Blauvelt, Roger M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 5th, 2006
Last updated Feb 14th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932187341 NPPES
Washington Other 5677BL REGENCE
Washington Other 172908 REGENCE
Washington Other GAB38443 REGENCE
Washington Other 1101260 REGENCE
Washington MEDICAID 1101260 REGENCE

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