Healthcare Provider Details

I. General information

NPI: 1225824782
Provider Name (Legal Business Name): BENJAMIN BRECHT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2025
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date: 11/11/2025
Reactivation Date: 01/13/2026

III. Provider practice location address

811 MADISON ST
EVERETT WA
98203-4543
US

IV. Provider business mailing address

PO BOX 2569
EVERETT WA
98213-0569
US

V. Phone/Fax

Practice location:
  • Phone: 425-212-4200
  • Fax: 425-212-4201
Mailing address:
  • Phone: 425-212-4200
  • Fax: 425-212-4201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: