Provider Demographics
NPI:1932162518
Name:BRINKMAN, WILLIAM J (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:BRINKMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13215 SE MILL PLAIN BLVD
Mailing Address - Street 2:STE C8-901
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-6963
Mailing Address - Country:US
Mailing Address - Phone:360-892-9664
Mailing Address - Fax:360-892-9667
Practice Address - Street 1:400 NE MOTHER JOSEPH PL
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-3200
Practice Address - Country:US
Practice Address - Phone:360-892-9664
Practice Address - Fax:360-892-9667
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000421822085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID807275000Medicaid
WA8425456Medicaid
WAP00225474OtherRR MEDICARE
WA8853933Medicare PIN
WA8425456Medicaid