Individual
BENJAMIN KOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1959 NE PACIFIC ST, BOX 356465, SEATTLE, WA 98195-0001
(206) 616-5207
(206) 685-8100
Mailing address
1959 NE PACIFIC ST, BOX 356465, SEATTLE, WA 98195-0001
Taxonomy
Speciality
Code
Description
License number
State
2084N0008X
Neuromuscular Medicine (Psychiatry & Neurology) Physician
Primary
60652306
WA
2084N0400X
Neurology Physician
A126449
CA
2084N0400X
Neurology Physician
MD181184
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500738375
—
OR
Enumeration date
04/30/2012
Last updated
08/23/2022
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