Healthcare Provider Details

I. General information

NPI: 1770304271
Provider Name (Legal Business Name): BRAWTA PSYCHIATRIC CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2024
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16404 SMOKEY POINT BLVD STE 103B
ARLINGTON WA
98223-8417
US

IV. Provider business mailing address

27402 CHURCH CREEK LOOP NW
STANWOOD WA
98292-9597
US

V. Phone/Fax

Practice location:
  • Phone: 425-404-1616
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MOSIAH ALPHANSO WILSON
Title or Position: OWNER
Credential: PMHNP
Phone: 425-404-1616