Individual provider · NPI-1

Jennifer Kooiker Benson, MD

Family Medicine · Mount Vernon, WA

NPI number1801899182

StatusActive

Last updated in NPPESOct 25, 2021

Details

NPI: 1801899182
Entity type: Individual (NPI-1)
Name: Mrs. Jennifer Kooiker Benson
Credential: MD
Sex: Female
Sole proprietor: No
Enumeration date: May 31, 2005
Certification date: Oct 25, 2021
Last updated: Oct 25, 2021

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207Q00000X	Family Medicine	MD00037772	WA	Yes

Other names

Jennifer R Kooiker (Former Name)

Practice location

110 N Laventure Rd Ste C
Mount Vernon, WA 98273-3901

Phone 360-399-7700 · Fax 360-899-4534

Mailing address

1400 E Kincaid St
Mount Vernon, WA 98274-4127

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