Individual
MATTHEW JAMES BENAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2525 NE 139TH ST STE 280, VANCOUVER, WA 98686-2719
(360) 882-2778
(360) 604-1780
Mailing address
PO BOX 4825, PORTLAND, OR 97208-4825
(360) 882-2778
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD61034769
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2159830
—
WA
Enumeration date
05/18/2016
Last updated
10/14/2020
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