Individual
BENJAMIN JAMES KEVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1804 W UNION AVE, SUITE 101, TACOMA, WA 98405-2062
(253) 251-2557
(253) 393-9187
Mailing address
11711 NE 12TH ST, STE 3A, BELLEVUE, WA 98005-2461
(425) 450-9474
(425) 452-0704
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT60096549
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12247688
CAQH
WA
01
—
PT60096549
STATE LICENSE
WA
Enumeration date
09/08/2009
Last updated
05/27/2020
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