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General NPI Number Information
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NPI Number | 1184572513
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Entity Type | Organization
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Legal Business Name | BENTON INTEGRATIVE HEALTH
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Dates
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Enumeration Date | 03/20/2026
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Last Update Date | 03/20/2026
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Provider Practice Location Address
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Address Line | 819 SE MORRISON ST STE 140
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City | PORTLAND
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State | OR
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Zip | 97214-6309
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Country | US
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Telephone | 503-954-6489
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Fax |
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Provider Business Mailing Address
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Address Line | 1718 NE 64TH AVE
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City | PORTLAND
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State | OR
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Zip | 97213-4732
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Country | US
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Telephone | 503-954-6489
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LESA JOY BENTON
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Credential | NP
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Telephone | 503-954-6489
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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