Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2082S0105X | Plastic Hand Surgeon | 252-09-00121-22 | WA |
NPI | 1255576971 |
---|---|
Provider Name | James F Brinkman |
First Address | Spokane, WA 99203-0407 |
Second Address | Spokane, WA 99223-8342 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2008 |
Last Update Date | 09/12/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1006004 | (05) | WA |
13603 | LABOR AND INDUSTRY (01) | WA |
A07108 | (02) | WA |
BRKMN00909 | PREMERA BLUE CROSS (01) | WA |