Individual
DR. BENIS P. BABUSIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19020 33RD AVE W STE 210, LYNNWOOD, WA 98036-4748
(425) 563-1500
(425) 563-1501
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
2085B0100X
Body Imaging Physician
Primary
MD00039582
WA
2085R0202X
Diagnostic Radiology Physician
M-12313
ID
2085R0202X
Diagnostic Radiology Physician
MD00039582
WA
2085R0202X
Diagnostic Radiology Physician
S-4958
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1017303
—
AK
05
—
1669450979
—
ID
01
—
189083
L&I PROVIDER NUMBER
WA
01
—
189085
L&I PROVIDER NUMBER
WA
01
—
189093
L&I PROVIDER NUMBER
WA
05
—
8286056
—
WA
Enumeration date
01/06/2006
Last updated
03/28/2018
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