Provider Demographics
NPI:1457463028
Name:BRINKLEY, CAROLINE S (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:S
Last Name:BRINKLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:SUSAN
Other - Last Name:JAMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25850 75TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:VASHON
Mailing Address - State:WA
Mailing Address - Zip Code:98070-8522
Mailing Address - Country:US
Mailing Address - Phone:206-408-7046
Mailing Address - Fax:
Practice Address - Street 1:25850 75TH AVE SW
Practice Address - Street 2:
Practice Address - City:VASHON
Practice Address - State:WA
Practice Address - Zip Code:98070-8522
Practice Address - Country:US
Practice Address - Phone:206-408-7046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00047277207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0237098OtherL&I
WA8469793Medicaid
G8874502Medicare PIN