Provider Demographics
NPI:1649327776
Name:PINTO, BENJAMIN N (MD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:N
Last Name:PINTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3980 129TH PL SE
Mailing Address - Street 2:B-201
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-5293
Mailing Address - Country:US
Mailing Address - Phone:206-601-6149
Mailing Address - Fax:206-219-5598
Practice Address - Street 1:3980 129TH PL SE APT B201
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-5293
Practice Address - Country:US
Practice Address - Phone:206-601-6149
Practice Address - Fax:206-219-5598
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA28124207RG0300X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8527749Medicaid