Individual
GABRIELLE LAURA BENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
108 S MAIN AVE, RIDGEFIELD, WA 98642-3820
(541) 610-9429
Mailing address
506 MAPLE ST, RIDGEFIELD, WA 98642-4507
(541) 610-9429
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
12400
OR
225700000X
Massage Therapist
Primary
MA61335708
WA
Other
Enumeration date
04/03/2007
Last updated
12/06/2023
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