Individual
DR. BRANDON BRUCE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.T., L.A.T.
Contact information
Practice address
6307 RICH RD SE, OLYMPIA, WA 98501-5317
(360) 587-0686
(360) 359-7756
Mailing address
6307 RICH RD SE, OLYMPIA, WA 98501-5317
(360) 587-0686
(360) 359-7756
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PU 60159680
WA
2251S0007X
Sports Physical Therapist
PU 60159680
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A1 60054681
ATHLETIC TRAINER LICENSE
WA
01
—
PU 60159680
PHYSICAL THERAPIST INTERIM PERMIT
WA
Enumeration date
06/08/2010
Last updated
05/12/2026
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