Provider Demographics
NPI:1811042435
Name:LOW, BENSON P (PHD)
Entity Type:Individual
Prefix:DR
First Name:BENSON
Middle Name:P
Last Name:LOW
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 BROADWAY STE 313
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-4304
Mailing Address - Country:US
Mailing Address - Phone:206-860-0860
Mailing Address - Fax:206-860-2829
Practice Address - Street 1:1001 BROADWAY STE 313
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-4304
Practice Address - Country:US
Practice Address - Phone:206-860-0860
Practice Address - Fax:206-860-2829
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00000697103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical