Healthcare Provider Details

I. General information

NPI: 1013926617
Provider Name (Legal Business Name): MURRAY A BEIGHTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 11/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 228TH ST SW
BOTHELL WA
98021-9799
US

IV. Provider business mailing address

6307 147TH ST SW
EDMONDS WA
98026-3649
US

V. Phone/Fax

Practice location:
  • Phone: 425-742-7953
  • Fax: 425-742-3683
Mailing address:
  • Phone: 425-742-7953
  • Fax: 425-742-3683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0155926
Identifier TypeOTHER
Identifier StateWA
Identifier IssuerDEPT LABOR INDUSTRY
# 2
Identifier7110935
Identifier TypeMEDICAID
Identifier StateWA
Identifier Issuer
# 3
IdentifierCJ5535
Identifier TypeOTHER
Identifier State
Identifier IssuerRAIL ROAD MEDICARE

VIII. Authorized Official

Name: DR. MURRAY A BEIGHTON
Title or Position: SOLE PROPRIETOR SUPERVISING PHYSICI
Credential: MD
Phone: 425-742-7953