Provider Demographics
NPI:1881657302
Name:SAXEY, RODERICK N (MD)
Entity Type:Individual
Prefix:DR
First Name:RODERICK
Middle Name:N
Last Name:SAXEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19020 33RD AVE W STE 210
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-4748
Mailing Address - Country:US
Mailing Address - Phone:425-563-1500
Mailing Address - Fax:425-563-1374
Practice Address - Street 1:19020 33RD AVE W STE 210
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-4748
Practice Address - Country:US
Practice Address - Phone:425-563-1500
Practice Address - Fax:425-563-1501
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000312852085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA327599OtherL&I PROVIDER ID
WA1021276Medicaid
WA0341947OtherL&I PROVIDER ID
WA0341946OtherL&I PROVIDER ID
WA327606OtherL&I PROVIDER ID
WAP01301612Medicare PIN
WAG8926162Medicare PIN
WA327606OtherL&I PROVIDER ID
WA1021276Medicaid
WAG8926163Medicare PIN