Healthcare Provider Details

I. General information

NPI: 1962110155
Provider Name (Legal Business Name): BENJAMIN WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2022
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 5TH AVE SE
OLYMPIA WA
98501-6918
US

IV. Provider business mailing address

106 5TH AVE SE
OLYMPIA WA
98501-6918
US

V. Phone/Fax

Practice location:
  • Phone: 360-930-9369
  • Fax:
Mailing address:
  • Phone: 360-930-9369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: BRANDON BENJAMIN
Title or Position: LAC, LMT
Credential:
Phone: 360-930-9369