Individual
MICA BENNER-KENAGY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2400 NE 95TH ST, SEATTLE, WA 98115-2426
(206) 525-5050
Mailing address
22204 38TH AVE W, MOUNTLAKE TERRACE, WA 98043-4237
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
225X00000X
Occupational Therapist
Primary
OT61532987
WA
Other
Enumeration date
01/29/2021
Last updated
10/30/2024
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