Organization
NORTHWEST MEDICAL GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRANDON PENIX DO, MPH (OWNER)
(509) 350-4785
Entity
Organization
Contact information
Practice address
938 W 3RD AVE, MOSES LAKE, WA 98837-2011
(509) 350-4785
(509) 380-9591
Mailing address
938 W 3RD AVE, MOSES LAKE, WA 98837-2011
(509) 350-4785
Taxonomy
Speciality
Code
Description
License number
State
163WX0106X
Occupational Health Registered Nurse
—
—
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
—
—
2083P0901X
Public Health & General Preventive Medicine Physician
—
—
2083X0100X
Occupational Medicine Physician
Primary
—
—
225100000X
Physical Therapist
—
—
225700000X
Massage Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0471864
LABOR AND INDUSTRIES
WA
Enumeration date
06/15/2023
Last updated
12/30/2024
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