Provider Demographics
NPI:1508250432
Name:JONES, BENJAMIN BLAINE (MD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:BLAINE
Last Name:JONES
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 1:3911 CASTLEVALE RD
Mailing Address - Street 2:STE 301
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-7807
Mailing Address - Country:US
Mailing Address - Phone:509-966-7899
Mailing Address - Fax:509-225-6811
Practice Address - Street 1:3911 CASTLEVALE RD
Practice Address - Street 2:STE 301
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-7807
Practice Address - Country:US
Practice Address - Phone:232-439-0776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-28
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10118459-1205207N00000X
WAMD61111284207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology