Individual
AMANDA BENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3857 MARTIN WAY E, OLYMPIA, WA 98506-5268
(360) 704-7170
Mailing address
3857 MARTIN WAY E, OLYMPIA, WA 98506-5268
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100903
—
WA
Enumeration date
06/05/2018
Last updated
06/05/2018
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