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Contact Information

RODERICK W BEAVER, MD
174 1ST AVE N
ILWACO, WA98624-9137
 Phone: 360-448-0587
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for RODERICK W BEAVER · (Male)

NPI Number 1689615692
Status Active
Credentials MD
Entity Individual
Enumeration date 06/09/2006
Last updated 12/02/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • WA License # MD00041270
  • WA Medicaid 1016271
  • WA Medicaid 8323198
Hospital affiliation(s)
  • OCEAN BEACH HOSPITAL - (Critical Access)
    174 FIRST AVENUE NORTH
    ILWACO, WA 98624
  • PEACHEALTH ST JOHN MEDICAL CENTER - (Acute Care)
    1615 DELAWARE STREET
    LONGVIEW, WA 98632
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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