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Individual

BENJAMIN HENRY BIASELLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
AAC

Contact information

Practice address
6221 NE FOURTH PLAIN BLVD APT 130, VANCOUVER, WA 98661-7210
(360) 831-0908
Mailing address
6221 NE FOURTH PLAIN BLVD APT 130, VANCOUVER, WA 98661-7210
(360) 831-0908

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10007
WA
Enumeration date
12/21/2022
Last updated
12/21/2022
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