Individual
BRENT MAXWELL WILKINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1420 AHTANUM RIDGE DR, UNION GAP, WA 98903-1839
(509) 454-7700
Mailing address
PO BOX 719, SUNNYSIDE, WA 98944-0719
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OP61315661
WA
208D00000X
General Practice Physician
OP61315661
WA
390200000X
Student in an Organized Health Care Education/Training Program
OL61064949
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2160431
—
WA
Enumeration date
05/29/2020
Last updated
12/20/2023
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