Provider Demographics
NPI:1427054469
Name:BENSON, DAVID R (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:R
Last Name:BENSON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5920 100TH STREET SW SUITE 8
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499
Mailing Address - Country:US
Mailing Address - Phone:253-584-1777
Mailing Address - Fax:253-584-0645
Practice Address - Street 1:5920 100TH ST SW STE 8
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-2751
Practice Address - Country:US
Practice Address - Phone:253-584-1777
Practice Address - Fax:253-584-0645
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2015-01-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WA27848207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1112499Medicaid
WABE0097OtherBLUE CROSS BLUE SHIELD
WA40206OtherWORK COMP
WAGAB20941Medicare PIN
WA40206OtherWORK COMP