Larry Leon Beach, O.D.

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

OD00001150 Issued in WA

Practice address

3915 Talbot Rd S
Suite 209
Renton, WA 98055-5738

Phone

(425) 235-9911

Fax

(425) 254-8807

NPI assigned

Jun 22, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1306882600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 TALBOT RD S",
            "address_2": "SUITE 209",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555738",
            "telephone_number": "425-235-9911",
            "fax_number": "425-254-8807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 TALBOT RD S",
            "address_2": "SUITE 209",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555738",
            "telephone_number": "425-235-9911",
            "fax_number": "425-254-8807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEACH",
        "first_name": "LARRY",
        "middle_name": "LEON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "WA",
            "license": "OD00001150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2025096",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jamie Baylor
• Baze Chiropractic, PLLC
• Carl Randolph Baze, D.C.
• Nataliya Arkadyevna Bazelyuk
• Be the Change Clinic LLC
• Beatty and Cottam PLLC
• Bruce Beauchamp, L.P.N.
• Andie Beck, M.S., CCC-SLP
• Mackenzie Anne Becker, OTD, OTR/L
• Tara Becker, PT

• Corneal and Contact Management Optometrist in Renton, WA
• Providers in Renton, WA by specialty
• Corneal and Contact Management Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.