Individual
MR. BENJAMIN C KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.P.
Contact information
Practice address
800 SPRAGUE AVE, SUITE #104, WALLA WALLA, WA 99362-3900
(509) 540-7211
(888) 972-3661
Mailing address
83068 LOWER DRY CREEK RD, MILTON FREEWATER, OR 97862-7328
(509) 540-7211
(888) 972-3661
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00014190
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4750KI
PROVIDER RIDER NUMBER
WA
Enumeration date
04/23/2007
Last updated
06/02/2016
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