Provider Demographics
NPI:1639171333
Name:FLOYD, DON BENJAMIN (DPM)
Entity type:Individual
Prefix:DR
First Name:DON
Middle Name:BENJAMIN
Last Name:FLOYD
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 188TH ST SW STE 110
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-4757
Mailing Address - Country:US
Mailing Address - Phone:425-778-5666
Mailing Address - Fax:425-771-5374
Practice Address - Street 1:3500 188TH ST SW STE 110
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98037-4757
Practice Address - Country:US
Practice Address - Phone:425-778-5666
Practice Address - Fax:425-771-5374
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPO00000346213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1115633Medicaid
WAR44453OtherREGENCE BLUE SHIELD
WA0157056OtherLABOR AND INDUSTRIES
WA0157056OtherLABOR AND INDUSTRIES
WA1115633Medicaid
WA4617710001Medicare NSC