Provider Demographics
NPI:1871364471
Name:FELDMAN, BENJAMIN
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:FELDMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:BEN
Other - Middle Name:MARC
Other - Last Name:FELDMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:325 S UNIVERSITY RD STE 101
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-6164
Mailing Address - Country:US
Mailing Address - Phone:509-921-9798
Mailing Address - Fax:
Practice Address - Street 1:325 S UNIVERSITY RD STE 101
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-6164
Practice Address - Country:US
Practice Address - Phone:509-921-9798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT61518168225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist