Brandy Mikel Wilson, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

P161515318 Issued in WA

Practice address

PO Box 634
Everson, WA 98247-0634

Phone

(360) 966-4810

NPI assigned

Jun 26, 2024

Last updated

Feb 1, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Brandy Mikel Martinez Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Foothills Physical Therapy LLC

  • Physical Therapist
  • Everson, WA
  • NPI 1467470658
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1719360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738368000000",
    "number": "1821833328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 ORLEANS ST # 102",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982263542",
            "telephone_number": "907-713-4259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 634",
            "city": "EVERSON",
            "state": "WA",
            "postal_code": "982470634",
            "telephone_number": "360-966-4810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BRANDY",
        "middle_name": "MIKEL",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-26",
        "last_updated": "2025-02-01",
        "certification_date": "2025-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P161515318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDY",
            "last_name": "MARTINEZ",
            "middle_name": "MIKEL",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christine Vaughan, OTR/L
• Rikki Vaughn
• Robert Eugene Watson, M.D.
• Whatcom County Fire Protection District 1 (Whatcom County Fire District #1)
• Alison Marie Wigbers, ARNP
• Gabe Raphael Wortman, ARNP
• Lauren Wright, MS, CCC-SLP

• Physical Therapy Assistant in Everson, WA
• Providers in Everson, WA by specialty
• Physical Therapy Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.