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General NPI Number Information
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NPI Number | 1518809698
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Entity Type | Individual
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Provider Name | BENJAMIN MBELLE
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Gender | Male
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Dates
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Enumeration Date | 04/07/2026
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Last Update Date | 04/07/2026
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Provider Practice Location Address
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Address Line | 7006 TURQUOISE DR SW
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City | LAKEWOOD
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State | WA
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Zip | 98498-6429
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Country | US
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Telephone | 253-212-0136
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Fax | 253-590-0820
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Provider Business Mailing Address
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Address Line | 7006 TURQUOISE DR SW
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City | LAKEWOOD
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State | WA
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Zip | 98498-6429
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Country | US
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Telephone | 253-212-0136
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Fax | 253-590-0820
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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 | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | 753634
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License Number State | WA
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