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Organization
EASTSIDE PATHOLOGY INC PS
Active
Organization
EASTSIDE PATHOLOGY INC PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENT DAVID BENJAMIN M.D. (PRESIDENT)
(425) 251-5168
Entity
Organization
Contact information
Practice address
1035 116TH AVE NE, BELLEVUE, WA 98004-4604
(425) 688-5000
(425) 688-5959
Mailing address
PO BOX 100559, FLORENCE, SC 29501-0559
(843) 664-4300
(843) 664-4308
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
MD00032601
WA
207ZD0900X
Dermatopathology (Pathology) Physician
MD00032601
WA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD00041011
WA
Other
Enumeration date
04/13/2006
Last updated
06/06/2008
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