Provider Demographics
NPI:1831224369
Name:BENOIT, MICHELLE F (MD)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:F
Last Name:BENOIT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3181 SW SAM JACKSON PARK RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3011
Mailing Address - Country:US
Mailing Address - Phone:503-418-4500
Mailing Address - Fax:503-494-4473
Practice Address - Street 1:1180 N INDIAN CANYON DR STE E218
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4885
Practice Address - Country:US
Practice Address - Phone:760-323-6511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00047666207VX0201X
CAC192007207VX0201X
ORMD208267207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX163374501Medicaid
TX8B3348Medicare ID - Type Unspecified