Individual
BRENT D. KOOY
Active
Individual
BRENT D. KOOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-2774
ID
363AM0700X
Medical Physician Assistant
PA10004744
WA
363AS0400X
Surgical Physician Assistant
PA-2774
ID
363AS0400X
Surgical Physician Assistant
PA10004744
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8418030
—
WA
Enumeration date
01/17/2007
Last updated
04/22/2026
Update your record
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