Individual
BENJAMIN PAYNTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D
Contact information
Practice address
2280 MARCOLA ROAD, SPRINGFIELD, OR 97477-2594
(541) 747-4300
Mailing address
2280 MARCOLA ROAD, SPRINGFIELD, OR 97477-2594
(541) 747-4300
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3165
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500775973
—
OR
Enumeration date
02/06/2017
Last updated
04/13/2020
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