Individual
DR. KENT GEORGE BENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1111 NE 99TH AVE, SUITE 301, PORTLAND, OR 97220-9428
(503) 963-2707
(503) 963-2802
Mailing address
847 NE 19TH AVE, SUITE 300, PORTLAND, OR 97232-2684
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD12769
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
266510
—
OR
05
—
8269573
—
WA
Enumeration date
08/11/2005
Last updated
11/11/2021
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