Healthcare Provider Details

I. General information

NPI: 1821552886
Provider Name (Legal Business Name): BENJAMIN HOFFMAN LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2019
Last Update Date: 01/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1138 NW MARKET ST
SEATTLE WA
98107-3710
US

IV. Provider business mailing address

1505 NE 166TH ST
SHORELINE WA
98155-6007
US

V. Phone/Fax

Practice location:
  • Phone: 206-783-0404
  • Fax:
Mailing address:
  • Phone: 360-540-6644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60769222
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: