Healthcare Provider Details

I. General information

NPI: 1649327776
Provider Name (Legal Business Name): BENJAMIN N PINTO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 01/27/2022
Certification Date: 01/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3980 129TH PL SE APT B201
BELLEVUE WA
98006-5293
US

IV. Provider business mailing address

3980 129TH PL SE B-201
BELLEVUE WA
98006-5293
US

V. Phone/Fax

Practice location:
  • Phone: 206-601-6149
  • Fax: 206-219-5598
Mailing address:
  • Phone: 206-601-6149
  • Fax: 206-219-5598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number28124
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: