Provider Demographics
NPI:1740757038
Name:BENSON, KRISTIN LEE STANDISH
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:LEE STANDISH
Last Name:BENSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:LEE
Other - Last Name:STANDISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:207 W NORA AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-4848
Mailing Address - Country:US
Mailing Address - Phone:425-681-9093
Mailing Address - Fax:
Practice Address - Street 1:316 W BOONE AVE STE 777
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2323
Practice Address - Country:US
Practice Address - Phone:509-217-1768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health