Provider Demographics
NPI:1376362483
Name:PACIFIC NORTHWEST KAIZEN, PLLC
Entity type:Organization
Organization Name:PACIFIC NORTHWEST KAIZEN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:S
Authorized Official - Last Name:FASBINDER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:253-777-3919
Mailing Address - Street 1:1201 PACIFIC AVE STE 646
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98402-4301
Mailing Address - Country:US
Mailing Address - Phone:253-777-3919
Mailing Address - Fax:253-263-7065
Practice Address - Street 1:1201 PACIFIC AVE STE 646
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-4301
Practice Address - Country:US
Practice Address - Phone:253-777-3919
Practice Address - Fax:253-263-7065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty