Individual
DR. SETH BRIAN GILLHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
401 W POPLAR ST, WALLA WALLA, WA 99362-2846
(509) 897-5850
Mailing address
401 W POPLAR ST, WALLA WALLA, WA 99362-2846
(509) 897-5850
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD60703695
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2069878
—
WA
Enumeration date
08/18/2011
Last updated
05/20/2021
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