Individual
DR. BENJAMIN P PISCIOTTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
939 CAROLINE ST, PORT ANGELES, WA 98362-3909
(360) 417-7000
Mailing address
939 CAROLINE ST, PORT ANGELES, WA 98362-3909
(360) 417-7000
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD00020748
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8553505
—
WA
01
—
9160PI
REGENCE BLUE SHIELD RIDER
—
01
—
P00177500
RAILROAD MEDICARE
—
Enumeration date
03/10/2006
Last updated
07/19/2007
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