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Individual

MR. LEIF BENJESTORF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ARNP

Contact information

Practice address
19109 36TH AVE W, SUITE # 209, LYNNWOOD, WA 98036-5767
(206) 569-8457
(425) 673-7586
Mailing address
19109 36TH AVE W, SUITE # 209, LYNNWOOD, WA 98036-5767
(206) 569-8457
(425) 673-7586

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN00174674
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP60201664
WA

Other

Enumeration date
08/21/2009
Last updated
08/07/2015
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