Provider Demographics
NPI:1487288445
Name:CASTILLA, BENJAMIN C
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:C
Last Name:CASTILLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3109 L ST NE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-2306
Mailing Address - Country:US
Mailing Address - Phone:206-356-5857
Mailing Address - Fax:
Practice Address - Street 1:3109 L ST NE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-2306
Practice Address - Country:US
Practice Address - Phone:206-356-5857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-28
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker