Basic Information
| Provider Information | |||||||||
| NPI: | 1467068437 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GARFINKEL | ||||||||
| FirstName: | BENJAMIN | ||||||||
| MiddleName: | CARY | ||||||||
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| Credential: | PHYSICIAN ASSISTANT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3636 FRANCIS AVE N APT 302 | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981038586 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2065889956 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | NA | ||||||||
| Address2: | |||||||||
| City: | NA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9999999999 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/16/2020 | ||||||||
| LastUpdateDate: | 09/16/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/15/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | TA61103502 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
ID Information
| ID | Type | State | Issuer | Description | 1176793 | 01 | NCCPA | OTHER |