| Benjamin Wibonele, MD | |
|
104 27th Ave Se, Puyallup, WA 98374-1145 | |
| (253) 770-9000 | |
| (253) 770-9712 |
| Full Name | Benjamin Wibonele |
|---|---|
| Gender | Male |
| Speciality | Otolaryngology |
| Experience | 6 Years |
| Location | 104 27th Ave Se, Puyallup, Washington |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285255448 | NPI | - | NPPES |
| 2338134 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Y00000X | Otolaryngology | MD61666933 (Washington) | Primary |
| 207YX0901X | Otolaryngology - Otology & Neurotology | MD61666933 (Washington) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Swedish Medical Center / Cherry Hill | Seattle, WA | Hospital |
| Multicare Good Samaritan Hospital | Puyallup, WA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Proliance Surgeons Inc P S | 8527972900 | 395 |
| Entity Name | Proliance Surgeons Inc P S |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023170313 PECOS PAC ID: 8527972900 Enrollment ID: O20031119000128 |
| Mailing Address | Practice Location Address |
|---|---|
| Benjamin Wibonele, MD Po Box 1205, Puyallup, WA 98371-0231 Ph: (253) 770-9000 | Benjamin Wibonele, MD 104 27th Ave Se, Puyallup, WA 98374-1145 Ph: (253) 770-9000 |
Dr. Todd Dwyer Jones, M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 104 27th Ave Se, Puyallup, WA 98374 Phone: 253-770-9000 Fax: 253-770-9712 |
Dr. Dennis R. Elonka, M.D. Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 6415 82nd St E, Puyallup, WA 98371 Phone: 253-691-0823 |
Vivian Mae Yu, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 104 27th Ave Se, Puyallup, WA 98374 Phone: 253-770-9000 Fax: 253-770-9712 |
Julie Allina Gustafson, M.D. Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 104 27th Ave Se, Puyallup, WA 98374 Phone: 253-848-0368 Fax: 253-435-4937 |
Shanik J Fernando, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 104 27th Ave Se, Puyallup, WA 98374 Phone: 253-770-9000 Fax: 253-770-9712 |
Randall Paul Bennett, MD Otolaryngology Medicare: Medicare Enrolled Practice Location: 104 27th Ave Se, Puyallup, WA 98374 Phone: 253-770-9000 Fax: 253-770-9712 |
Douglas D Backous, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 104 27th Ave Se, Puyallup, WA 98374 Phone: 253-770-9000 Fax: 253-770-9712 |