Individual
BENJAMIN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1401 MADISON ST STE 400, SEATTLE, WA 98104-1316
(206) 386-6111
(206) 386-6113
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD60490088
WA
207Q00000X
Family Medicine Physician
ML60293615
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60490088
—
WA
01
—
MD60490088
MEDICAL LICENSE NUMBER
WA
01
—
ML60293615
MEDICAL LICENSE NUMBER
WA
Enumeration date
06/20/2012
Last updated
07/03/2015
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