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Individual

MRS. KAY MICHELLE BROOKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA C

Contact information

Practice address
4254 JACKSON HWY, CHEHALIS, WA 98532-8424
(360) 262-3966
(360) 262-3967
Mailing address
PO BOX 1099, MORTON, WA 98356-0018
(360) 496-5145
(360) 496-5093

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
PA0004588
WA
363AM0700X
Medical Physician Assistant
Primary
PA10004588
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1117829
WA
05
7132244
WA
05
7132764
WA
Enumeration date
11/14/2005
Last updated
07/10/2015
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