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Individual

DR. BENJAMIN WALTER DONALD ILES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
500 17TH AVE, SEATTLE, WA 98122-5711
(206) 320-3700
(206) 320-5955
Mailing address
19020 33RD AVE W STE 210, LYNNWOOD, WA 98036-4748
(425) 563-1500
(425) 563-1374

Taxonomy

Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
OP61040926
WA
2085R0202X
Diagnostic Radiology Physician
5101025913
MI
2085R0202X
Diagnostic Radiology Physician
Primary
OP61040926
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0427470
L&I-RADIA REST OF WA
WA
01
0427471
L&I-RADIA KING CTY
WA
01
0427472
L&I-SWEDISH RADIA EDMONDS
WA
01
0427473
L&I-EVERGREEN RADIA
WA
01
0427475
L&I-SOUTH SOUND
WA
01
0427477
L&I-SEATTLE RADIOLOGY
WA
01
0427478
L&I-VANCOUVER RADIOLOGY
WA
05
2155919
WA
Enumeration date
03/10/2014
Last updated
12/30/2025
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