Healthcare Provider Details

I. General information

NPI: 1235959578
Provider Name (Legal Business Name): HANNAH BENSON OTD, OTR/L
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2024
Last Update Date: 10/11/2024
Certification Date: 10/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20818 44TH AVE W STE 270-P
LYNNWOOD WA
98036-7709
US

IV. Provider business mailing address

12331 40TH AVE NE
SEATTLE WA
98125-5730
US

V. Phone/Fax

Practice location:
  • Phone: 425-672-2716
  • Fax: 425-672-2720
Mailing address:
  • Phone: 425-516-9900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0008X
TaxonomyPediatric Neurodevelopmental Disabilities Physician
License NumberOT.OT.61597508
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License NumberOT.OT.61597508
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT.OT.61597508
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: