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Contact Information

BENSON VISION SOURCE, INC.
25022 104TH AVE SE STE D
KENT, WA98030-2822
 Phone: 253-859-1911
 Fax: 253-859-5084
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for BENSON VISION SOURCE INC · (Female)

NPI Number 1679601512
Status Active
Credentials
Entity Individual
Enumeration date 03/01/2007
Last updated 11/26/2012 - About 14 years ago
Sole proprietor 1 Not specified
Identifiers
  • WA License # OD00003501
  • WA Medicaid 2026748
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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