Individual
BRANDON LANE WHITLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AG-ACNP
Contact information
Practice address
1119 HIGHLAND AVE STE 7, CLARKSTON, WA 99403-2836
(509) 758-1119
Mailing address
PO BOX 189, CLARKSTON, WA 99403-0189
(509) 758-1119
(509) 758-1140
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
65287
ID
363LF0000X
Family Nurse Practitioner
Primary
AP61081911
WA
Other
Enumeration date
10/15/2009
Last updated
05/29/2025
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