| Doctor Name: | DR. MATTHEW JAMES BENNETT |
| NPI Number: | 1003954330 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSYD |
| License Number: | PY60482081 |
| Business Practice Address: | 1400 112th Ave Se Suite 100 Bellevue, WA - 980046901 |
| Business Phone Number: | 4256067548 |
| Business Fax Number: | 4256570844 |
| Mailing Address: | 2246 Nw Harmony Way, ISSAQUAH |
| State: | WA |
| Postal Code: | 980275488 |
| Phone Number: | 4256067548 |
| Fax Number: | 4256570844 |
| NPI Enumeration Date: | 02/01/2007 |
| NPI Last Update Date: | 03/16/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PY60482081 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |