Individual provider Active NPI

Daniel Bender

  • General Practice Physician
  • Tacoma, WA
National Provider Identifier
1235993163
Registry record updated Apr 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
0101287870 Issued in VA
Practice address
9040 Jackson Ave
Tacoma, WA 98431-0001
Phone
(253) 968-2417
NPI assigned
Feb 12, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 0101287870 VA Primary

Addresses

Primary practice location

9040 Jackson Ave
Tacoma, WA 98431-0001

Mailing address

9040 Jackson Ave
Tacoma, WA 98431-0001
Phone (253) 968-2417

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240910004228 WA Order and Referring Only - UrologyPractitioner - Urology 3274073804

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0101287870VAMDGeneral Practice Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1235993163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-2417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-2417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENDER",
        "first_name": "DANIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-12",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101287870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.