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Individual

BROOKE ASHLEY WETHINGTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
22394 MIFLIN RD STE 104, FOLEY, AL 36535-9593
(251) 318-0053
(251) 215-6731
Mailing address
1706 WASHINGTON WAY, PO BOX 1338, LONGVIEW, WA 98632-1701
(360) 423-0390
(360) 423-6230

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8224
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1136537
NCCPA
GA
01
8224
PA LICENSE NUMBER
GA
01
PA.60855522
WA STATE LICENSE NUMBER
WA
Enumeration date
12/27/2016
Last updated
05/01/2023
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