Kay Michelle Brooks, PA C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA10004588 Issued in WA

Practice address

4254 Jackson Hwy
Chehalis, WA 98532-8424

Phone

(360) 262-3966

Fax

(360) 262-3967

NPI assigned

Nov 14, 2005

Last updated

Jul 10, 2015By 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 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436486400000",
    "number": "1831170158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1099",
            "city": "MORTON",
            "state": "WA",
            "postal_code": "983560018",
            "telephone_number": "360-496-5145",
            "fax_number": "360-496-5093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4254 JACKSON HWY",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985328424",
            "telephone_number": "360-262-3966",
            "fax_number": "360-262-3967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "KAY",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-14",
        "last_updated": "2015-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10004588",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "PA0004588",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7132244",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7132764",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1117829",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edgar Fabian Bravo
• Marlene Brewer, LMP
• Brooke Ann Briggs, L.M.P.
• Shelby Ryan Briggs, LMT
• Douglas Brooks
• Shawn Brown
• Kady Elizabeth Bruce, OTD, OTR/L
• Cassandra Lynn Bruhn
• Ashley M Bryan, CNA
• Roberta D. Bryan, SUDP, AAC, CPC

• Medical Physician Assistant in Chehalis, WA
• Providers in Chehalis, WA by specialty
• Medical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2015; 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.