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General NPI Number Information
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NPI Number | 1023995404
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Entity Type | Individual
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Provider Name | BENJAMIN RAY GALLAGHER LMT
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Gender | Male
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Dates
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Enumeration Date | 08/19/2025
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 2702 1/2 N PROCTOR ST APT E
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City | TACOMA
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State | WA
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Zip | 98407-5243
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Country | US
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Telephone | 425-463-9158
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Fax |
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Provider Business Mailing Address
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Address Line | 20010 RIDGE RD SW
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City | VASHON
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State | WA
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Zip | 98070-6266
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Country | US
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Telephone | 425-463-9158
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA60943475
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License Number State | WA
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