Jaderholm, Benjamin Wells
Jaderholm, Benjamin Wells is an individual health care provider with primary practice located at 1326 N Stanford Ln , Liberty Lake WA 99019-5034. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Jaderholm, Benjamin Wells can be contacted via phone (509) 838-2531.Contact Information
Primary practice address
1326 N Stanford Ln
Liberty Lake WA 99019-5034
Phone: (509) 838-2531
Fax: (509) 755-6580
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | 58.007627 | Ohio |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | OP60804314 | Washington |
Profile Details
| NPI number | 1093128027 |
|---|---|
| LBN Legal business name | Jaderholm, Benjamin Wells |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 6th, 2014 |
| Last updated | Apr 27th, 2018 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093128027 | NPPES |
| Ohio | MEDICAID | 0159060 |
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