Provider Demographics
NPI:1770612095
Name:TONEY, BENJAMIN ARON (MA)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:ARON
Last Name:TONEY
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 88
Mailing Address - Street 2:611 WEST TACOMA AVE
Mailing Address - City:WESTPORT
Mailing Address - State:WA
Mailing Address - Zip Code:98595-0269
Mailing Address - Country:US
Mailing Address - Phone:360-669-9005
Mailing Address - Fax:
Practice Address - Street 1:402 YAUGER WAY SW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-8660
Practice Address - Country:US
Practice Address - Phone:360-878-8248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-04
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00044686101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health