MEDICARE: MR. DANIEL HARRY BENSON DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251X0800X	Orthopedic Physical Therapist	2326PT	MT
2	2251X0800X	Orthopedic Physical Therapist	PT 60300653	WA

General Provider Information

NPI Number	:	1861705576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DANIEL HARRY BENSON DPT

Provider Business Mailing Address
First Line	:	714 N 65TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-5306
Country	:	US
Telephone Number	:	231-468-9395
Fax Number	:

Provider Business Practice Location Address
First Line	:	714 N 65TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-5306
Country	:	US
Telephone Number	:	231-468-9395
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2010
Last Update Date	:	09/14/2012

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