Individual
BENJAMIN KENNETH GAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2502 E FOURTH PLAIN BLVD, VANCOUVER, WA 98661-3965
(360) 831-0904
Mailing address
PO BOX 34703, SEATTLE, WA 98124-1703
(253) 681-6603
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CG61357226
WA
Other
Enumeration date
09/16/2022
Last updated
09/16/2022
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