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Individual

DEANE BENNINGHOVEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CH, CI

Contact information

Practice address
950 BROADWAY STE 402, TACOMA, WA 98402-4454
(253) 229-9932
Mailing address
2817 S D ST, TACOMA, WA 98402-1105
(253) 229-9932

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
HP60959702
WA

Other

Enumeration date
02/15/2024
Last updated
04/23/2024
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