Provider Demographics
NPI:1548548126
Name:GILHAM, BENJAMAN JAMES (AUD, D)
Entity type:Individual
Prefix:
First Name:BENJAMAN
Middle Name:JAMES
Last Name:GILHAM
Suffix:
Gender:M
Credentials:AUD, D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2921 NACHES AVE SW
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-2617
Mailing Address - Country:US
Mailing Address - Phone:206-630-5737
Mailing Address - Fax:206-630-1601
Practice Address - Street 1:2921 NACHES AVE SW
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-2617
Practice Address - Country:US
Practice Address - Phone:206-630-5737
Practice Address - Fax:206-630-1601
Is Sole Proprietor?:No
Enumeration Date:2011-07-29
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALD60233276231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist