Provider Demographics
NPI:1750397071
Name:TINNEL, BRENT ALLAN (MD)
Entity type:Individual
Prefix:DR
First Name:BRENT
Middle Name:ALLAN
Last Name:TINNEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4230 BRIDGEPORT WAY W STE B
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-4335
Mailing Address - Country:US
Mailing Address - Phone:253-627-6325
Mailing Address - Fax:253-627-8792
Practice Address - Street 1:3920 CAPITAL MALL DR SW STE 100B
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-8186
Practice Address - Country:US
Practice Address - Phone:360-706-6370
Practice Address - Fax:360-706-6464
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2022-02-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA01012397412085R0001X
WAMD601949232085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology