Active NPI
Deane Benninghoven, CH, CI
- Specialist
- Tacoma, WA
National Provider Identifier
1629833975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- HP60959702
- Practice address
- 950 Broadway Ste 402
Tacoma, WA 98402-4454 - Phone
- (253) 229-9932
- NPI assigned
- Feb 15, 2024
- Last updated
- Apr 23, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | HP60959702 | WA | Primary |
Addresses
Primary practice location
950 Broadway Ste 402
Tacoma, WA 98402-4454
Mailing address
2817 S D St
Tacoma, WA 98402-1105
Phone (253) 229-9932
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| HP60959702 | WA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713830400000",
"number": "1629833975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2817 S D ST",
"city": "TACOMA",
"state": "WA",
"postal_code": "984021105",
"telephone_number": "253-229-9932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "950 BROADWAY STE 402",
"city": "TACOMA",
"state": "WA",
"postal_code": "984024454",
"telephone_number": "253-229-9932"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNINGHOVEN",
"first_name": "DEANE",
"credential": "CH, CI",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-02-15",
"last_updated": "2024-04-23",
"certification_date": "2024-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "HP60959702",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.