Individual
DR. KENNY BENJAMIN LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D
Contact information
Practice address
1865 NW 169TH PL, SUITE 105, BEAVERTON, OR 97006-7327
(503) 533-8441
(503) 533-8403
Mailing address
17184 SW ARTESIAN DR, BEAVERTON, OR 97006-4990
(503) 533-8441
(503) 533-8403
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2878AT
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181436
—
OR
Enumeration date
06/28/2006
Last updated
07/08/2007
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