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General NPI Number Information
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NPI Number | 1376362483
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Entity Type | Organization
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Legal Business Name | PACIFIC NORTHWEST KAIZEN, PLLC
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Dates
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Enumeration Date | 10/07/2024
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 1201 PACIFIC AVE STE 646
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City | TACOMA
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State | WA
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Zip | 98402-4301
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Country | US
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Telephone | 253-777-3919
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Fax | 253-263-7065
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Provider Business Mailing Address
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Address Line | 1201 PACIFIC AVE STE 646
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City | TACOMA
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State | WA
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Zip | 98402-4301
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Country | US
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Telephone | 253-777-3919
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Fax | 253-263-7065
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | BENJAMIN S FASBINDER
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Credential | D.O.
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Telephone | 253-777-3919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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