Dr. Benjamin Lee Waldo
Optometrist Optomitrist - Corneal and Contact Lenses
13912 Ne 20th Ave Suite 200
Vancouver
, Washington 98686-1465
Dr. Benjamin Lee Waldo
Optometrist Optomitrist - Corneal and Contact Lenses
13912 Ne 20th Ave Suite 200
Vancouver
, Washington 98686-1465
(360) 574-6030
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About
Features
Specialties
- Optometrist
- Optomitrist - Corneal and Contact Lenses
Languages spoken
- English
Location
First Address
- Dr. Benjamin Lee Waldo
- 13912 Ne 20th Ave Suite 200
- Vancouver, WA
- Zip : 98686-1465
- Phone : (360) 574-6030
Second Address
- Dr. Benjamin Lee Waldo
- 13912 Ne 20th Ave Suite 200
- Vancouver, WA
- Zip : 98686-1465
- Fax : (360) 574-4116
- Phone : (360) 574-6030
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 60022188 OD | WA |
| N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | WV1020OD | WV |
National Provider Identifier
| NPI | 1194780361 |
|---|---|
| Provider Name | Dr. Benjamin Lee Waldo |
| First Address | Vancouver, WA 98686-1465 |
| Second Address | Vancouver, WA 98686-1465 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/04/2006 |
| Last Update Date | 02/09/2009 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 00112571000 | (05) | WV |
| 0150205000 | (05) | WV |
| VO4606 | (02) | WV |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.