Provider Demographics
NPI:1407956568
Name:BEEGLE, EARL D (MD)
Entity Type:Individual
Prefix:
First Name:EARL
Middle Name:D
Last Name:BEEGLE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:909 N BROADWAY
Mailing Address - Street 2:PBO
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-1409
Mailing Address - Country:US
Mailing Address - Phone:425-317-0279
Mailing Address - Fax:425-317-0291
Practice Address - Street 1:12800 BOTHELL EVERETT HWY
Practice Address - Street 2:SUITE 120
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-6642
Practice Address - Country:US
Practice Address - Phone:425-316-5150
Practice Address - Fax:425-316-5153
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2009-02-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00019801207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8366668Medicaid
WAA09363Medicare UPIN
WAG8878380Medicare PIN
WAG8878188Medicare PIN
WA8366668Medicaid