Healthcare Provider Details

I. General information

NPI: 1770116279
Provider Name (Legal Business Name): TANYA BENN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2020
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2008 WESTLAKE AVE STE 100
SEATTLE WA
98121-2695
US

IV. Provider business mailing address

2008 WESTLAKE AVE STE 100
SEATTLE WA
98121-2695
US

V. Phone/Fax

Practice location:
  • Phone: 206-956-9570
  • Fax: 206-448-8495
Mailing address:
  • Phone: 206-956-9570
  • Fax: 206-448-8495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: