Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | PO00000251 | WA |
NPI | 1023388451 |
---|---|
Provider Name | Dr. Benjamin Mark Scapa |
First Address | Redmond, WA 98052-3807 |
Second Address | Redmond, WA 98052-3807 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2012 |
Last Update Date | 02/01/2012 |