Individual
DR. GARY GORDON BENJAMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1304 FAWCETT AVE STE 100, TACOMA, WA 98402-1900
(253) 761-4200
(253) 761-4201
Mailing address
PO BOX 1535, TACOMA, WA 98401-1535
(253) 761-4200
(253) 383-3553
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
MD00034148
WA
2085R0202X
Diagnostic Radiology Physician
MD21111
OR
2085R0204X
Vascular & Interventional Radiology Physician
Primary
MD00034148
WA
2085R0204X
Vascular & Interventional Radiology Physician
MD21111
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0127162
L&I-TRA KING COUNTY
WA
01
—
0186167
L&I-UNION AVE OPEN MRI
WA
01
—
0335999
L&I-TRA REST OF WA
WA
01
—
0372658
L&I-DIAGNOSTIC IMAGING NW
WA
05
—
1031136
—
WA
05
—
500670859
—
OR
Enumeration date
11/16/2006
Last updated
05/13/2019
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