Lee, Kenny Benjamin
Lee, Kenny Benjamin is an individual health care provider with primary practice located at 1865 Nw 169Th Pl Suite 105, Beaverton OR 97006-7327. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Lee, Kenny Benjamin can be contacted via phone (503) 533-8441.Contact Information
Primary practice address
1865 Nw 169Th Pl Suite 105
Beaverton OR 97006-7327
Phone: (503) 533-8441
Fax: (503) 533-8403
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2878AT | Oregon |
Profile Details
| NPI number | 1619905866 |
|---|---|
| LBN Legal business name | Lee, Kenny Benjamin |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 28th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1619905866 | NPPES |
| Oregon | MEDICAID | 181436 |
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