Individual
BENJAMIN MICHAEL GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
505 S 336TH ST, SUITE 500, FEDERAL WAY, WA 98003-5947
(206) 962-3490
Mailing address
505 S 336TH ST, SUITE 500, FEDERAL WAY, WA 98003-5947
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
00048011
WA
207Q00000X
Family Medicine Physician
MT184803
PA
Other
Enumeration date
12/14/2006
Last updated
11/04/2015
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