Provider Demographics
NPI:1316278625
Name:ZEPEDA, BENJAMIN J (DC)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:J
Last Name:ZEPEDA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16700 NE 79TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-4465
Mailing Address - Country:US
Mailing Address - Phone:425-861-3832
Mailing Address - Fax:425-861-3808
Practice Address - Street 1:16700 NE 79TH ST STE 101
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-4465
Practice Address - Country:US
Practice Address - Phone:425-861-3832
Practice Address - Fax:425-861-3808
Is Sole Proprietor?:No
Enumeration Date:2010-01-26
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60132467111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor