Provider Demographics
NPI:1477990901
Name:BERENSON, LES MEYER (MD)
Entity Type:Individual
Prefix:DR
First Name:LES
Middle Name:MEYER
Last Name:BERENSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6603 AURORA AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-5324
Mailing Address - Country:US
Mailing Address - Phone:206-290-0409
Mailing Address - Fax:
Practice Address - Street 1:6603 AURORA AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-5324
Practice Address - Country:US
Practice Address - Phone:206-290-0409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-23
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00019511207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine