Waldo, Benjamin Lee

Waldo, Benjamin Lee is an individual health care provider with primary practice located at 14201 Ne 20Th Ave Ste A102 , Vancouver WA 98686-6411. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Waldo, Benjamin Lee can be contacted via phone (360) 574-6030.

Contact Information

Primary practice address
14201 Ne 20Th Ave Ste A102 Vancouver WA 98686-6411
Fax: (360) 574-4116
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X WV1020OD West Virginia
Eye and Vision Services Providers / Optometrist 152W00000X 60022188 OD Washington

Profile Details

NPI number 1194780361
LBN Legal business name Waldo, Benjamin Lee
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 19th, 2006
Last updated Jan 24th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194780361 NPPES
West Virginia MEDICAID 00112571000
West Virginia MEDICAID 0150205000

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