Healthcare Provider Details

I. General information

NPI: 1780502153
Provider Name (Legal Business Name): BENJAMIN SWENSEN CCC-SLP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 N RIVERPOINT BLVD STE V
SPOKANE WA
99202-0002
US

IV. Provider business mailing address

310 N RIVERPOINT BLVD STE V
SPOKANE WA
99202-0002
US

V. Phone/Fax

Practice location:
  • Phone: 509-505-7481
  • Fax:
Mailing address:
  • Phone: 509-505-7481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number61237238
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: