Individual
DANIEL FISK BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9330 59TH AVE SW, LAKEWOOD, WA 98499-2858
(253) 581-7020
Mailing address
9330 59TH AVE SW, LAKEWOOD, WA 98499-2858
(253) 620-5012
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7346243588
VA HEALTHCARE
WA
Enumeration date
07/10/2020
Last updated
07/10/2020
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