Provider Demographics
NPI:1154370906
Name:BEGLIN, PETER ALAN (MD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:ALAN
Last Name:BEGLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1115 SE 164TH AVE
Mailing Address - Street 2:DEPT 358
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-9324
Mailing Address - Country:US
Mailing Address - Phone:360-734-2700
Mailing Address - Fax:360-734-8362
Practice Address - Street 1:2979 SQUALICUM PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225
Practice Address - Country:US
Practice Address - Phone:360-734-2700
Practice Address - Fax:360-734-8362
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00037530207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
42030OtherREGENCE BS
WA0280175OtherL&I AND CRIME VICTIMS PHMG
132167OtherL&I
WA060067477OtherRAILROAD MEDICARE
WA82107OtherL&I AND CRIME VICTIMS SJMC
WA8243479Medicaid
8924851OtherL&I CRIME VICTIMS
WA1154370906Medicaid
WA4683BEOtherREGENCE BLUE SHIELD
5124486OtherAETNA
WAG009OtherTRI WEST (TRICARE)
AKMD4683WMedicaid
WAG009OtherTRI WEST (TRICARE)
42030OtherREGENCE BS
WAGAB10061Medicare PIN
WA0280175OtherL&I AND CRIME VICTIMS PHMG
WA060067477OtherRAILROAD MEDICARE