Individual
IAN MOORE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
314 NE THORNTON PL, SEATTLE, WA 98125-9000
(206) 520-2300
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 520-5700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD60572230
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992740518
—
WA
Enumeration date
06/18/2006
Last updated
10/22/2015
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