Individual
MICHAEL BROCKWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
313 S 9TH AVE, YAKIMA, WA 98902-3516
(509) 248-8040
(509) 248-8709
Mailing address
313 S 9TH AVE, YAKIMA, WA 98902-3516
(509) 248-8040
(509) 248-8709
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
OI 00000188
WA
224P00000X
Prosthetist
Primary
PS 00000189
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8418956
—
WA
05
—
9045675
—
WA
Enumeration date
07/26/2007
Last updated
03/14/2013
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