Provider Demographics
NPI:1669358685
Name:BENSON, GAYLE DIANNE (LPN)
Entity type:Individual
Prefix:
First Name:GAYLE
Middle Name:DIANNE
Last Name:BENSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3240 NORTHWEST AVE
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1318
Mailing Address - Country:US
Mailing Address - Phone:360-450-5025
Mailing Address - Fax:360-734-3270
Practice Address - Street 1:3240 NORTHWEST AVE
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1318
Practice Address - Country:US
Practice Address - Phone:360-450-5025
Practice Address - Fax:360-734-3270
Is Sole Proprietor?:No
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC53268164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse