Provider Demographics
NPI:1548345283
Name:STARNES, BENJAMIN (MD)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:STARNES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1416 18TH AVE UNIT C
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-3094
Mailing Address - Country:US
Mailing Address - Phone:206-323-1099
Mailing Address - Fax:206-299-3088
Practice Address - Street 1:2211 QUEEN ANNE AVE N
Practice Address - Street 2:SWEDISH PHYSICIANS
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-2313
Practice Address - Country:US
Practice Address - Phone:206-861-8500
Practice Address - Fax:206-861-8501
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO394472080P0204X
WAMD00048997208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO91735742Medicaid
CO91735742Medicaid
H46970Medicare UPIN