Provider Demographics
NPI:1861705576
Name:BENSON, DANIEL HARRY (DPT)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:HARRY
Last Name:BENSON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 N 65TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-5306
Mailing Address - Country:US
Mailing Address - Phone:231-468-9395
Mailing Address - Fax:
Practice Address - Street 1:714 N 65TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-5306
Practice Address - Country:US
Practice Address - Phone:231-468-9395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-22
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2326PT2251X0800X
WAPT 603006532251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic